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By Xavier Mercader Psychological Impacts of Taking Care of a Child with a Heart Condition
I’m sure anyone who’s had a child, will agree that the birth of your first, is one of the most blissful moments in life. As new parents, you spent time reading about how to take care of a child (as if there was an actual manual for it). You prepare your future child’s bedroom, make lists of what they’ll need, buy clothes and attend prenatal classes. All in preparation for the day that will change your life. But no matter how well you think you’re prepared, whether or not you’re a first-time parent or if it’s your fourth child, I don’t believe anyone is ever fully ready for it. In my case, my wife and I were lucky – she had a really easy pregnancy. She felt great the entire time and was even going to the gym three days before her due date. Even the delivery felt easier than I thought it would – not that I was going to do the hard part – but men are usually more afraid than their pregnant counterparts; even if they won’t admit it. Our daughter was taking her time, so my wife was induced. The epidural shot worked great, and my wife was even able to take a nap before showtime. After forty-five minutes of active labour, we met our daughter and I even cut the cord without fainting! The first month felt like it went by in the wink of an eye. We were tired and obviously sleep-deprived, but we couldn’t be happier to have welcomed our daughter into our lives. The News During one of our regular check-ups, the doctor told us she noticed our little one had an odd way of breathing. So, we were referred to a pediatrician. The pediatrician didn’t see anything odd with her breathing but told us he could hear a murmur. He said it was probably just a murmur, but suggested it might be good to go to the ER to get it checked out. I don’t remember how many hours we spent at the ER or how many tests they ran. All I remember is hearing a doctor, at 2 AM, telling us “we are going to admit you” to the hospital. Our one-month-old daughter had a heart condition called Ventricular Septal Defect (VSD), that was causing her ventricular hypertrophy and as a result, was filling up her lungs with fluid. In one day, all that happiness and bliss turned into fear, uncertainty and doubt. We felt powerless, unable to do anything but sit and wait for the doctors to tell us the plan. How everything changedAfter a week, we were cleared from the hospital and given prescriptions to give to our daughter. Captopril to help her heart work better, and two diuretics – one to get rid of captopril once it had its effect as it has a certain level of toxicity, and the other one to reduce the fluid in her lungs. So as new parents, that a month before didn’t even know how to change a diaper, now had to cope with administering three different medications. Giving a child that young medication is extremely challenging; we had to ensure she swallowed them, without spitting them out or choking. Most times, we were lucky if she swallowed half. We were unprepared for this. One morning when giving her her medication, before leaving for work, I thought she was swallowing them just fine. Until she started to turn red. She was unable to breathe for a few seconds. I turned her over and patted her back till she finally spat it all out. I’ve never been more scared in my life. The thought that I could’ve lost her, had me shaking and as a result, I was unable to go to work. The days I did go to work were weird. Some days, it felt like everything was ok and other days, I could barely hold back tears. But most days when I came home I would find my wife crying. Typically I’m good at cheering her up, but this was different, there was nothing I could say or do to help. I worried about that a lot. I felt useless, unable to ease my wife’s pain. At times, being able to leave my place for a few hours, felt like a mental break from everything. But at the same time, I couldn’t stop worrying about my wife and daughter at home. It was tense 24/7. We would put our baby to bed, try to relax, watch some tv, but we couldn’t. Our Next Steps In another check-up, the cardiologist told us our daughter would likely need open-heart surgery. But all we could do is wait and see how everything goes. It would all depend on how well she was gaining weight. If she started to gain weight normally, it was possible she wouldn’t need the surgery. But if she continued below the growth charts, it would mean her heart condition was keeping her from growing normally (this is what they call failure to thrive). So, we tried our best to get her to eat better. But how would she gain any weight if she was taking two diuretics three times a day and she wasn’t finishing her bottles? Every time we went to her check-ups, she was below the growth charts. And every time we were told the same thing. “It’s too early to decide, let’s see how everything goes”. This made every feeding time tense. All we could think was “I hope she eats a bit more now”. After a few months of stress, we went from not wanting our baby to have surgery, to wanting her to have it. We didn’t actually want our baby to have to go through surgery, but we did want her heart fixed and to be able to leave the stress behind us. With time, our little one started to gain weight. We were told she was doing well but still needed to wait to decide about the surgery. Our, now toddler, was able to play and do all the things other children do, so we started to relax slightly. We couldn’t stop worrying completely, but at last, we received some good news. At her last check-up, we were told she won’t need surgery after all. She will be able to live a normal life. The Connection with Mental HealthTaking care of a child with any health condition is sure to take a toll on the mental health of their parents. In my experience, parents feel stressed, depressed, helpless and a sense of unfairness asking themselves “why does this have to happen to OUR baby?” This feeling of unfairness, also makes us feel alone and isolated. I remember going to one last prenatal class to meet with the group of parents after all our babies were born, to share our experiences about giving birth. There were approximately 13 couples and most of them shared bad experiences: they had either during the final stages of pregnancy or during labour, but all of their babies were healthy. They had the ability to look back to those difficult experiences with a smile. When it was finally our turn, we didn’t have a bad labour experience to share, only our baby’s heart problem. And that made us feel very alone. What I Learned About Managing Mental Wellness Although everyone’s experience is different, the following are my personal tips for a parent dealing with a similar issue.
Conclusion Caring for a child with a heart condition or other illness is a situation that no parent is prepared for. It can be physically and emotionally taxing to not only manage the realities of a child’s illness, like giving my young daughter medication, but also the fears associated with the illness and the unknowns that can come with that. Even though during this time you likely want to spend all of your energy taking care of your child, it’s also important to take time for your own mental health. Overall, you will be better able to take care of your child and manage the illness if you’re also taken care of. By Susi Bolender, RCC Vulnerability and Letting Go
In a time of uncertainty, our brains are hardwired for wanting to establish some control. Unfortunately, so much of life is beyond our control which leaves us feeling stressed out, anxious, and even depressed. For many of us, the idea of letting go is counterintuitive and opens us up to feeling vulnerable. But there’s nothing wrong with being vulnerable, in fact, being vulnerable is not only good for us but also helps us to form connections and improve our relationships. Brene Brown and Vulnerability At TEDxHouston in June 2010, Brené Brown did a groundbreaking talk on courage, vulnerability, shame, and empathy. This talk not only launched her work into the mainstream, but has spread the mission to own our stories and create meaning from experiences that are holding us back throughout the world. (You can watch the TEDx talk here). In 2018, I was fortunate enough to travel to Houston to train in two of her programs: The Daring Way and Rising Strong. The Daring Way focuses on courage-building, shame resilience, and uncovering the power of vulnerability. Rising Strong has the following objectives:
Through these programs, participants are encouraged to give themselves permission. Permission to be curious and open-minded, to take time to explore their feelings, to dig deep and not have all the answers, but instead find courage as they develop a way to own their stories and write endings in a way that feels best for them. During these programs, it’s also important to be mindful about being connected to how we’re feeling and intentional about breathing to develop stability as we work through the corners of our life experiences and relationships with others. We can think about vulnerability in terms of how we choose to understand and tell our story. What is Vulnerability We all have beliefs about what vulnerability means. It’s often connected to the idea of weakness – in other words, the belief that being emotional is a sign of weakness and that emotions shouldn’t be discussed openly. Most people don’t know how to talk about emotions. And, to be honest, we’re often too busy to even know how we feel. We may subconsciously think, ‘what we don’t know can’t hurt us’ – but just because we don’t acknowledge our emotions, doesn’t mean they aren’t impacting us. These ideas about vulnerability keep us cut off from developing meaningful bonds with people in our lives. They keep us separate, alone and fearful of connection. Vulnerability is defined by Brene Brown as “uncertainty, risk, and emotional exposure.” The idea that vulnerability is weakness is the opposite of her message. Rather, viewing risking our vulnerability as being courageous is a way to build our confidence and deepen our relationships with ourselves and others. What prevents us from being vulnerable?As mentioned previously, when we are faced with uncertainty, it’s automatic for us to want to maintain control. This is the opposite of being vulnerable. Being vulnerable can be scary and it can open us up to the risk of getting hurt. As a result, many of us put up armour in order to avoid feeling vulnerable. Which, according to Brené, revolves around one of three methods:
In her work, Brené also talks about the idea of hustling for worthiness. In Gifts of Imperfection (a must-read, in my opinion!), Brené explains the idea of how we try to aim for perfection unnecessarily. Instead, we can start to get curious about why we behave the way we do and adjust our perspectives to open up to see that courage comes from the ability to practice being vulnerable. How to be more Vulnerable and Let Go
Participating in this program supports people to let go of perfectionism, fear, grief, sadness and self-judgement. We learn how to set boundaries with integrity and be generous with others to expect their best rather than fear their worst. There is also an opportunity to understand grief, loss, forgiveness, longing and feelings of being lost in your life. Some of these are very difficult and not often discussed, but vital in the process of letting go and developing vulnerability in owning our stories. Anxiety and criticism are other areas of focus and how we unhook from those powerful ways that we stay small. Result of the ProgramThe program is 16 lessons which can be done over 8 weeks. It culminates with a new, better-feeling story of our lives. A story that we created in a way that took ownership of our experiences, rather than let our experiences take over. The work helps us develop our vulnerability and see it as courage, to let go of old patterns and ways of thinking and live as the owner of our lives rather than a bystander. There are very few clinicians trained in the Daring Way and Rising Strong curriculum in Canada and fewer in British Columbia. I went to Houston, Texas in 2018 to have a fully immersive experience learning the material. I didn’t know what to expect, but participating in the training was life-changing. Working through these programs has helped me and so many of the people I am fortunate to support through their growth and change. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I suppose this is a problem of old age, but I think constantly about my ex-husband, who has been dead for almost 40 years. Could this be from unresolved trauma? It was not a happy marriage. The answer: Regularly thinking about someone who was an important part of your life – good or bad – even years or decades after they have died is not unusual. Grief is a mysterious creature and the process can be so unpredictable, and so very individual. Thoughts of someone who has died tend to be more frequent and intense when the death was of someone particularly close (a partner, a child). The grieving process is protracted when the death is untimely, unexpected or particularly traumatic or tragic. Having unresolved or complicated emotions from the relationship while the person was alive can also play a role, as you have alluded. As a society, we are strangely ill-equipped to deal with death. I am often asked questions about how long it will take to “get over” a loss, or how one can deal with “unresolved issues” when it comes to their grieving. My experience – both personally in dealing with the death of my father, as well as professionally – is that we never really get over the death of someone that was an important part of our life. We simply learn to cope better over time. Whether your thoughts are a problem depends on a few factors. First, when you say “constantly,” what do you mean? I have many patients who will describe thinking on a daily basis about their deceased loved one. A fleeting thought on most days, even decades later, is not necessarily unusual. Consider the intensity of the emotions associated with thoughts of your ex-husband. Are they neutral thoughts that pop in and out of your head, and don’t interfere with your day-to-day activities? Or, do you find you get stuck in a ruminative state that causes a high degree of emotional stress? There is no magic formula for how long it takes to cope well after a death. But most people will find that it can take from a few months to a few years to get back to their usual mood and activities, and have thoughts of their loved one without breaking down or becoming overly emotional. Four decades later, you still sound disturbed by the quality or quantity of thoughts you are having about your ex-husband – so clearly something needs to change. Spend some time reflecting on what impact his death had. Do you feel that there were unsaid things that you want to communicate to him that you never did? Do you have anger or regret at yourself for not doing things differently, such as leaving the marriage earlier? Are there elements of self-blame or shame for decisions you did or didn’t make? Have you made efforts to move on in your life, or is your past relationship still affecting current-day decisions? Doing some soul-searching on the above can help you move forward. Start by writing down your thoughts in a journal; every time you get stuck on a thought, note what it is specifically that’s in your head, and what it means about your life now. This can be a very powerful exercise. If you find this doesn’t make things better, joining a grief support group or seeking the help of a therapist may be of benefit. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Suicidal Thoughts: Making a Safety Plan
When someone is experiencing significant or persistent distress, or negative feelings, in their life, it’s easy to feel overwhelmed or hopeless about the future. Many people think about suicide because they’re looking for a way to escape the pain. If you’re thinking about suicide, know that you’re not alone and your feelings are valid. The best things you can do when you’re feeling suicidal are; make sure you are not alone, be in a safe place including making your home safe by getting rid of things you could use to kill yourself, and make a safety plan. What is a safety plan? A safety plan is a written set of instructions that you’re able to use when you’re feeling suicidal and may be at risk of hurting yourself. When using the safety plan, you start with the first item and work your way through escalating steps until you feel safe. It is helpful to make the safety plan with someone you trust. A therapist may be the best option, but a close friend or family member can also be helpful. It’s particularly important to get these people in your life involved because they’re the ones you’re likely to call for support when you need to execute the safety plan. It’s also helpful to create the safety plan when you’re not actively suicidal, and keep it in a place where it is easy to access when suicidal thoughts arise. How to create a safety plan Before starting to write down items on your safety plan, it can be helpful to determine the situations where using the safety plan is necessary. Consider the situations, thoughts, feelings, and behaviours that precede or accompany suicidal thoughts for you and when a safety plan would be most helpful. Next, see our free digital download Coping with Suicidal Thoughts where you can print and fill out a safety plan. The information below can help with filling out the safety plan. When making a safety plan, the following are the key elements you want to consider and have a ‘plan’ to do: 1 - What can I do to calm or comfort myself?
2 - What are my reasons for living
3 - Who can I talk to?
4 - Where can I go to be safe / how can I make my current environment safe?
5 - What can I do if I still don’t feel safe?
Final Thoughts Many people experience suicidal thoughts and it’s not something to be ashamed of. Having a safety plan helps you and your loved ones be prepared to keep you safe when you are feeling distressed. If you or somebody else is at immediate risk of suicide, call 9-1-1. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
Lately I’ve been feeling uninterested in socializing. All I want to do is stay home and have netflix marathons. I’ve been feeling like this for about two months. Should I be worried I’m no longer wanting to spend time with friends and family – which I used to enjoy? The answer: All of us can benefit from the occasional TV binge. It can give us time to unwind from the day-to-day grind of our lives and give us an opportunity to recharge. However, if your tendency to avoid people has been going on for weeks or months on end, there may be cause for concern. Periods of feeling down or sad are common for all of us; most of the time when we feel this way, we aren’t depressed. Usually, mood changes will go away on their own within a few days or weeks, especially as stressors that commonly cause these mood changes start to resolve. For some people, mood issues may continue for weeks or longer. If you find that you have been feeling sad or down and have had little interest in things you normally enjoy, like spending time with friends, for an extended period, it’s possible you are struggling with an emotional problem like depression. Depression is one of the most common psychological health conditions and affects one out of four people over the course of their lifetime. Contrary to popular belief, depression doesn’t always mean feeling sad or tearful – for some people, a “depressed” mood may feel like irritability or frustration, and for others it may be associated with feeling “flat” or feeling “nothing.” Depression comes along with other problems that may include:
If you are feeling any of the above – particularly if you are having dark thoughts – you should speak to your family doctor or a psychologist or psychiatrist. There are very effective treatments for depression, including cognitive-behavioural therapy, interpersonal therapy and, for some people, medication therapy. With time and the right treatment, you can get better. You may be able to access free services through your local mental health agency (see www.cmha.ca for a Canadian Mental Health Association office near you). By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  How to Practice Self-Compassion
We often hear that we need to be kinder and less critical of ourselves, but that’s easier said than done. Often, our self-critical thoughts have been developed over so many years that we hardly even notice them happening anymore. Or, at times, we may believe we need this type of ‘tough love’ in order to motivate ourselves to be better (that we will be ‘soft’ if we are too kind to ourselves). This is untrue. Repeated criticism results in increased levels of cortisol and adrenaline, which leads to the body trying to protect itself by beginning to shut down (e.g., depression). So, it’s important to be aware of those critical voices and challenge them when they come up. Engaging in the practice of challenging those self-critical voices is an act of self-compassion. What is Self-Compassion? Self-compassion is expressing kindness towards oneself, especially during times of pain and suffering. It includes:
There are three elements to self-compassion: 1 - Self-Kindness
2 - Common Humanity
3 - Mindfulness
What’s the difference between self-compassion and self-esteem? Sometimes people equate self-compassion with self-esteem which can make it difficult to believe that one can improve their skills when it comes to self-compassion. So, it’s important to know the difference. Self-esteem is typically used to describe a person’s feeling of self-worth, and while this is important, many people have a challenging time making significant changes to their self-esteem. Self-compassion on the other hand isn’t a judgement of self-worth or rooted in your value, it’s simply the act of treating yourself with kindness, care, and support. These are things you can do independent of self-esteem. Self-compassion offers the same well-being benefits without all the pitfalls such as fewer social comparisons, is less contingent on self-worth, has no association with narcissism, and buffers against negative effects of low self-esteem in adolescents. Self-compassion is also linked to better overall coping and resilience, as well as provides individuals with some of the following benefits:
How to Practice Self-Compassion It’s important to remember that self-compassion is going to take practice – it isn’t something you are going to develop or improve on overnight. That being said, it’s a practice that is worth investing in knowing the numerous benefits for your overall physical and psychological health, wellness and resilience. But how do we start practicing self-compassion? A great place to start is with mindfulness. To be compassionate towards yourself, you need to be mindful of your pain and suffering; recognize it, allow yourself to feel it, and embrace it. Mindfulness is a practice that helps you to become more attuned with your emotions and will help you to more easily identify the moments where self-compassion is needed and where your voice is the most self-critical. Once you’ve begun to recognize your self-critical voice, you can start to practice making changes to it and providing yourself with self-compassion in those moments instead. 6 ways to practice self-compassion:
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I recently have had a string of deaths in the family, all from cancer. Now I stress out about every little bump on my body. I’ve been to the doctors, who say I’m fine, but I’m still anxious all the time. What can I do to not feel crazy? The answer: My sincere condolences on the deaths in your family. I’ve had multiple family members deal with cancer diagnoses, some at a very young age, and can personally appreciate the significant emotional toll it takes on everyone, including close family and friends. To be feeling stressed and worried about your health is very normal given the circumstances. Our emotions – positive and negative – all serve a purpose. They provide us with validation about things that are important to us, they motivate us toward action, and they communicate things to people around us. In your case, your anxiety is providing your brain and body a few messages: First, cancer is a reality that could affect anyone. And secondly, there is value in being attentive to your health, and obtaining a professional opinion on risks or concerns you may have. Your worry is also helping to communicate to your loved ones – from whom you may need support – that you are feeling sad about those you’ve lost and that you have concerns about your own health and possible mortality. In all cases, there is a shelf life on the value our worry has. Worry (or any other negative emotion) is helpful insofar as it serves a useful function. It sounds as though you are recognizing that you are past a stage that is helpful. You have sought medical advice, which I will assume has included a comprehensive medical checkup from a physician you trust, and had your concerns allayed. To be in a state where you are overly stressing or ruminating about any minor change or bump even when you have been told there is nothing to be concerned about is clearly not serving a useful role, and it is impacting your quality of life. Once worry starts, it can easily grow exponentially simply being fed by our (often unrealistic) thoughts. So, it’s important to actively work on challenging your thoughts and making them more realistic. Ask yourself (and write down) the answers to the following key questions when you find yourself getting caught in a state of worry:
I’ve co-authored a book that you can download for free titled Positive Coping with Health Conditions. It offers useful, evidence-based chapters on relaxation strategies, managing worry, and managing depressive thinking (which can often be a side effect of worry). These chapters offer cognitive and behavioural strategies that have been proven to reduce worry. Another great book is Mind Over Mood: Change How You Feel by Changing the Way You Think, by Drs. Dennis Greenberger and Christine Padesky. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. The question:
I’ve been taking a low dose birth control pill for about a year now and I’m wondering how much of an effect the hormones can have on my mood. I’ve always suffered from mild anxiety, but lately I just don’t feel like myself. I could be fine one minute and the next I feel a rush of anxious energy, worry and sadness. Could it be the pills and should I stop taking them? The answer: Virtually any pharmaceutical – particularly one that is focused specifically on hormonal regulation – has the potential to impact mood. Sadness, anxiety, as well as irritability or sleeplessness are among the most common potential consequences. Speaking to your family doctor about the changes you have noticed is an important first step. There may be a pill that is a better fit for your body, or alternative forms of birth control may be options to consider. It is equally important for you to consider other situational or life events that may be impacting your anxiety. Interestingly, as humans we generally tend to be pretty poor and often inaccurate in our attributions of what factors affect our emotional and physical health. This can be chalked up to a case of being “too close to home” when it comes to factors that affect us. You say you’ve always suffered from mild anxiety – do you have a sense of what factors (situations, scenarios, concerns, people) contribute to the anxiety for you? Putting pen to paper and articulating in writing the personal contributors is a good way to gain some insight. What is going on in your life right now? Pay attention to changes that may be exacerbating your anxiety. Relationship conflict, work stress and financial concerns tend to be the most common culprits. Even positive life events – such as a having a baby, getting a promotion, or moving – tax our physical and emotional resources and can lead to our body feeling “stressed” (our body doesn’t discriminate between good stress and bad stress!). How is your health generally? Have you been exercising? Eating relatively balanced meals? Getting adequate amounts of sleep? Targeting these areas if they have fallen short, and also minimizing alcohol use, is important. The best way to make sense of triggers and contributing factors to your mood is to keep a daily diary for a week or two. Start from when you wake up, and make an hourly (or close to) entry of the following: your mood, what you are doing, and any particular thoughts you are aware you have been having. Review this with your family doctor, and ensure you have had an up to date physical examination as other health issues (e.g., anemia, thyroid dysregulation) could also be playing a role. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  How to Manage Feelings of Frustration
With all of the busyness of life, frustration can be a frequently occurring emotion, particularly when we are dealing with competing life and work demands. Here, we’ll address what causes us to feel frustration, how to manage feelings of frustration to decrease our frustration levels. What is frustration? Frustration is the feeling of being upset or annoyed, particularly because of our inability to change or achieve something. When we experience frustration, we often forget the cause of these feelings are often completely out of our control – and the ‘out of our control’ contributors to frustration often can even further amplify the feelings of frustration! (Isn’t that just frustrating?) How can we all better manage frustration?
Final Thoughts Personally, I find when my frustration levels increase, it’s usually because I’m feeling disorganized in life. So, what I do is intentionally reduce ‘extra’ demands in my life – which usually relates to non-essential or non-energizing social commitments – and use that time to catch up on housework, do laundry, get caught up and organized with paperwork that clutters my office, and do some meal planning so that I have one less To Do during the week. I also then commit no-alarms on Saturdays and Sundays so that I can catch up on much-needed sleep debt! We are only in charge of what we can control, so do what you can, and don’t sweat the small things! By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Self-Compassion Journaling – Journaling Prompts
Journaling can be a great way to set aside a specific time to engage in self-reflection. It gives you the opportunity to explore your emotions while also identifying patterns. When it comes to self-compassion, it gives you the opportunity to identify areas for growth and self-acceptance in our lives in an intentional way. It can also be a healthy and therapeutic way of expressing yourself, which can improve mood and help to de-stress. So, here we are going to talk about self-compassionate journaling and how to incorporate it into your life including journaling prompts How to Start Journaling Beginning any routine can be challenging, so it’s best to start with tangible ways of incorporating it into your daily routine. This can include picking a time to engage in a journaling practice, set a notification in your phone to remind you, and have a list of prompts prepared so if you don’t naturally have anything to write about, you have an alternative writing topic. Journaling Prompts that Focus on Self-Love Here is a list of prompts that can help you start thinking about self-compassion and the ways you can re-engage with self-love.
Final Thoughts Journaling is just one way to practice self-compassion, so if journaling isn’t for you, or you struggle to keep it as part of your routine, that’s okay. In most cases these things take practice, so it can be easy to get discouraged. |
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