Mental health IS health: Why don’t we treat our emotional health the same way we treat our physical health?
Most of us believe we should see a physician when we're sick.
Especially in this time of COVID, we get really, really nervous when we don't feel well. A lingering cough or runny nose? Headaches for a week? We recognize that "something's not right" and, whether we go to the doctor or not, we take steps to address our symptoms.
So, what stops you from going to therapy the same way you'd go to your PCP if you were sick?
While stigma around mental health is decreasing (and it's about dang time, am I right?!), a lot of people will never make it in to a therapist's office.
There are a lot of reasons behind this: not having health insurance or not being able to afford private pay as more therapists (myself included) move away from a broken insurance system that does not compensate providers fairly; not finding a therapist that looks like you (only about 5% of psychologists are Black, while 4% are Latinx); fears about judgment from your family or friends or worse, your therapist; not having paid leave from your job; competing priorities like care giving responsibilities and employment; or maybe it's a lack of anonymity if you live in a rural area where everybody knows everybody.
A shift to telehealth is addressing some of these problems; about 75% of therapists have taken their practice virtual since March. But, almost half of the country reports deteriorating mental health due to the pandemic.
Mental health smart phone app use is on the rise but some of the services offered on these apps aren't scientifically proven to help, and there aren't many regulations around app development. This means your private information might be shared or important information provided on the app might be incorrect.
So, how do mental health professionals like me support our communities at a time when more people than ever are struggling?
I'm still getting people outdoors to move their bodies and talk it out with hike therapy, and I've also increased access to therapy with video sessions.
But what if you're not feeling therapy and you just want to learn more about how to build solid mental health habits?
Self-paced, low cost, digital courses and small group coaching packages might be right up your alley. While these modalities are not a substitute for therapy, I think they can meet people where they're at right now, in these really unique times we're all in.
I'm going to be launching a course soon, and I'd love to know what health topics you'd be interested in learning about. Shoot me an email here.
What would help you NOW? What information do you need to move you towards healthier living, both physically and emotionally? I'd love to hear from you and offer some support.
Just email me at email@example.com and let me know what you're struggling with.
We are in this together.
I used to think there were two types of people. Those that got things done because they were strong and driven, full of willpower. And those who dreamed big dreams and talked about doing big things but lacked the self-discipline to follow-through. I was judgmental back then. Mostly judgmental towards myself, believing I fell in the second category. I lacked all understanding of the psychology of motivation, productivity, and behavior change.
I’ve been a therapist for 10 years now, and I’ve seen thousands of clients, each unique in what’s shaped them. Many carry the pain of trauma(s), and almost all of them have experienced some adverse event that affects the way they see themselves.
Now, I believe that everyone has the strength to do hard things. I understand that the difference between people who achieve their goals and those whose dreams lay dormant is in their beliefs about themselves. But, whether I think you are strong has little bearing on whether you will reach your full potential. Rather, what is it that YOU think about yourself?
When I didn’t believe I was strong enough, smart enough, or capable enough, I stood still. Overthinking, overanalyzing, in a state of “analysis paralysis.” Even when people told me I was strong and smart; I didn’t believe in my own capability. Up until then, I typically quit anything that got too tough, and it wasn’t until I proved my strength to myself by sticking through something hard that I started to believe in myself. Then I got curious about what else I could achieve.
I started proving to myself that I was capable through the practice of mastery.
Mastery is doing something that makes you feel confident and competent and gives you a sense of accomplishment. The activity must be hard enough that it’s challenging but not so hard that it’s impossible to achieve the first time you set out to do it. For example, if you’ve never run, mastery might mean running for 60 seconds without stopping and then gradually increasing over time. Mastery is trying activities that are new and sticking through when it gets hard, without setting yourself up for failure by choosing an activity that is going to be too difficult to begin with.
Mastery is about balance.
Nature led me to mastery, though it’s not what I was looking for. I was drawn to the outdoors as a way to stay connected to my dad after he passed away. I went on a short hike that made my body ache afterwards. And then I wondered, how far could I hike next time? And then, to what elevation? I started challenging myself and lo and behold, I started believing I could do harder things. Physically, mentally, and emotionally. In a world where I had been taught to be quiet and small, the outdoors gave me an opportunity to do things that made me feel big and powerful. Even when they were scary. I learned that you don’t have to be 100% confident that you’ll be successful in order to take risks. You just have to be confident that there’s A CHANCE of success. Years of building mastery has taught me that there’s ALWAYS a chance.
In mental health news, mastery builds resistance to depression and anxiety. It helps us feel confident, which improves our mood. It makes us feel more "in control" of our environment, which alleviates anxiety. It increases “feel good” emotions, like joy, peace, and contentment.
Many of us are not taught that mastery and self-compassion are keys to being motivated and “getting things done,” so I’ve created a coaching program to help women build these skills! We will explore the stories women tell themselves about motivation and willpower and how these stories actually create barriers to reaching goals. In this program, I’ve used psychological science to build simple strategies to create more energy and motivation. It launches July 14 and I’ll be releasing registration info in the coming weeks!
How do you build mastery? Leave a comment!
Goal setting is an important component of therapy and should happen early on. It provides a road map for both the therapist and the client each session and helps to keep us on track. Recently, I was having a session with a client and we were discussing her goal to reduce her binge eating episodes and replace them with healthier eating habits. I posed a question I typically ask all my clients: “What do you think has gotten in the way of making this change in the past?” And, I heard it! The statement I get from women (and men) time and time again. “Well, I guess I just don’t have enough willpower.”
You know that if you could reach your goals, you’d be happier and more fulfilled. How many times have you said to yourself, “If I just had more willpower, I’d… go back to school, write a book the world needs right now, read about how to communicate better with my partner, learn how to parent more effectively, get healthier and stick with it, pick up the hobby I’ve been saying I want to do for the last three years.” What comes next is all too familiar for most of us. We beat ourselves up a little more than last time, judge ourselves harshly, thinking we fell short again, and remain highly self-critical. We think if we’re just a little harder on ourselves it will generate a type of willpower that we don’t currently have but desperately need.
Here’s a secret. IT’S NOT ABOUT WILLPOWER. At least not completely. While self-discipline can help us reach our goals, research shows that SELF-COMPASSION can also help us stick to healthy behaviors. And for many, self-compassion is the first step in increasing self-control.
If you fall short but believe you can learn from the experience and do better next time, you are more likely to reach your goal over time. This growth mindset begins by challenging the myths you believe about yourself, like “I’m not strong enough or smart enough.” You develop a growth mindset not through willpower, but by exposing yourself to new and challenging situations with the goal of learning rather than performing perfectly. As you build feelings of worthiness, confidence, and self-compassion, you are less likely to quit when you make a mistake and more apt to keep pushing forward even as it remains difficult.
Spending time in nature can help you build these skills. You can engage in outdoor activities to bust the myths you believe about yourself, by hiking further than you’ve ever hiked, breaking a sweat, and pushing your limits with each outing. I’ve been running outdoors for about five years. It’s still not easy for me. Sure, it’s not as challenging to run a mile as it was when I first started but running is still difficult and may always be that way for me. I’m not naturally athletic, my heart rate elevates quickly, and a lot of my energy is spent focusing on regulating my breathing. What has changed about my running routine, however, is my ability to see each run as an opportunity to learn something about my body and how it works, try different breathing techniques, and practice gratitude. Focusing on my “why,” that is, the purpose behind why I run, has also helped me shift from thinking only about reaching my goals to one of challenging myself for the sake of growing.
I have heard client after client say that building more willpower is the answer to reaching their goals. I’ve worked with too many clients to count, helping them grow SELF-COMPASSION instead, so they can be kinder to themselves and less judgmental. And when they make these changes, they always start to move closer to their goals than when they were trying to shore up willpower alone. Because of both these professional experiences and my own personal one, I decided to create a coaching program that will explore the stories women tell themselves about motivation and willpower and how these stories actually create barriers to reaching their goals. I also aim to teach participants more helpful strategies for reaching goals, based on psychological science that includes harnessing the power of nature to create more energy and motivation. It launches next month and I can’t wait to share more about it in the coming weeks!
Dyouck, C. S. (2008). Mindset: The new psychology of success. New York : Ballantine Books.
Self-care is having a moment. From bubble baths, chocolate cake, and wine, my Instagram feed is littered with #selfcaresunday posts with this kind of content. And, don’t get me wrong. Treating ourselves can be self-care. As a mental health professional, I’m excited to see individuals, especially women, focused on taking care of their emotional and mental health. But, it’s not all about indulgence. More often than not, real self-care is the hard work of intentionally removing the things that give us short term relief but create long-term negative consequences to our mental health.
Enter social media. Like many of you, I have a complicated relationship with social. On the one hand, I can keep up with friends and family I don’t see enough. I appreciate the Events tab on Facebook, which has kept me in the loop about local shows, cultural activities, farmers markets, and the like. It’s easy to post to one central location so that my friends and family can keep up with me, too. In fact, many a conversation has started with, “So I saw on Facebook (or Instagram) that you were at (fill in the blank). How was that?”
But, a lot of the time, social media leaves me feeling less-than-fulfilled. Sure, I see friends and family post vacation pictures and their kids’ best moments, but I’m not there to experience that with them. We might exchange brief, shallow pleasantries, but it’s difficult to engage in the deep, meaningful conversations that I crave. After scrolling mindlessly for an hour (or more! Some of us spend up to six hours per day on social!) I’m often left feeling guilty or unsatisfied about not using the time more productively. I feel annoyed about a post sharing inaccurate, false information. And, let’s not forget the infamous political rants that can leave me feeling demoralized about the state of our country for hours afterwards. Social media, with its benefits, can be a toxic place. In fact, 15 million Americans left Facebook this year, citing the constant stream of negative news, rants, and political posts, and stating they needed a mental health break as their reasons for jumping ship.
In addition to the toxic environment that social media can often create, there are other insidious consequences to engaging in it heavily. It contributes to a more sedentary lifestyle and decreases real-time interactions, both known to contribute to depression. More young people feel ill-equipped to engage socially because most of their interactions take place through a screen. Many people report increased anxiety due to FOMO, the Fear Of Missing Out. Never-ending notifications disrupt our work, sleep, and relationships. Upward social comparison, comparing our worst moments to other people’s best, is particularly damaging for young girls. After all, most of us are sharing our lives through filters, and it becomes easy to forget that others’ feeds are simply a highlight reel of best moments with heavy editing.
The research paints a startling picture. The more time we spend on social media, the more depressed, anxious, and lonely we feel. Maybe we don’t connect our use with those feelings. For those who suffer with mental health issues already, it might be difficult to point to an episode on social media and say that it caused our negative emotions. I’d encourage you to become vigilant about the content you’re consuming and take stock of how you feel immediately before and after being on social media. While I don’t endorse a complete departure from social media because it’s next to impossible in our culture today (though if you are interested in that approach, Cal Newport is someone worth checking out), I do encourage a mindful, deliberate approach to using social media. Here are four strategies to start with.
If you are committed to self-care, consider decreasing your social media use. It will improve your mental health more than the myriad of short-term solutions that are being marketed throughout the wellness industry. Many of us struggle to fit self-care activities in on a regular basis. By giving up social media, you are freeing up your schedule to engage in the things and with the people that really matter. And, that’s real #selfcare.
As Suicide Prevention month continues, I wanted to clue you into a few vulnerable populations at greater risk of suicide than the general population. I feel particularly close to each of these groups for personal reasons. While scientists and researchers find cures for a variety of other public health crises, suicide remains on the rise for all of the US, except Nevada. I hope you’ll consider ways to help these groups if you can; I have included resources to learn more about how to donate, volunteer, and educate yourself more on the struggles each of these groups face.
Both of my grandfathers were Veterans and my uncle continues to serve our country proudly. I’ve provided psychotherapy to Veterans for the last five years, specifically Veterans experiencing homelessness. Veterans are the most loyal and service-driven group of men and women I have the pleasure of knowing and working with. Here’s the devastating statistic: Twenty-two Veterans kill themselves each day. Though it may appear Veterans have plenty of support in the way of community resources, many feel isolated and have trouble fitting in after they leave the military. The truth is, only about 7% of the American population is made up of Veterans. It makes sense that when you are the minority, it is difficult for the people around you to fully understand what you are going through. What are the challenges Veterans face today? 11-20% are diagnosed with PTSD, depending on the service era (e.g. Vietnam vs Gulf War vs Operation Enduring Freedom and Iraqi Freedom). In addition to combat, Veterans have higher rates of sexual trauma. Many suffer from depression and anxiety. They have higher rates of disability and are more likely to experience homelessness. Veterans carry invisible wounds of war that civilians could never know about unless we develop the courage to ask.
With so much attention focused on Veteran suicides, I was astonished when I read an article in 2017 stating farmers had suicide rates double that of Veterans. As the rural-urban divide grows, with approximately 80% of Americans calling urban and suburban areas home, it is hard to truly understand the plight of rural farmers. I have a unique perspective, my dad a fourth generation farmer and family members who continue to grow, pack, and ship. Growing up in a farming family, I saw firsthand the stress that a bad season brings, the impact it has on a marriage, the time farming takes away from family, the pressure to make ends meet. Factors outside of farmers’ control, like flooding, drought, and pests, can take a major toll on revenue. As global warming continues to wreak havoc on our planet, farmers face more adversity. Additionally, farming can be a socially isolating occupation, with many activities spent in solitude or with only your family members. Living in a remote area presents barriers to accessing mental health services; for example, growing up in rural south Texas in the 1990s, the nearest mental health professional was a 30 minute drive away. Add to this the typical stereotype of the stoic farmer, unwilling to admit there’s something wrong, plus higher access to lethal means, such as firearms and high-powered farm equipment, and we begin to paint a stark picture. States with vast rural areas, such as Montana, Alaska, and Wyoming carry the highest rates of suicide in the country.
Transgender men and women
Imagine feeling unsafe in your own community? 90% of trans people report facing prejudice and discrimination. They are shunned from their families and peer groups and harassed at churches, schools, and workplaces, finding themselves isolated and alone. They experience high rates of unemployment and homelessness, creating an immense amount of stress that most of us could never imagine. The transgender community is one of the most misunderstood groups today, with dangerous myths and completely false narratives spread about them. While there has been a light shed on the trans community recently, the truth is, trans folks have existed in cultures throughout recorded time. Transgender is a term that means a person’s gender identity is different than the sex they were assigned at birth, and research indicates there are at least 700,000 transgender people in the US (but many are justifiably scared of the risks of coming out, so this number is probably higher). Over 40% of trans folks have attempted suicide, with more than half of transgender male teens reporting an attempt. And yet, with all this adversity, transgender folks remain among the most resilient clients I have the opportunity of working with. When they connect with a loving and supportive community they thrive, and many contribute, create, make positive impacts on the community, and work for justice for all.
What can we do?
If you know a Veteran or farmer or trans man or woman personally, check in with them. Ask them how they’re doing. Invite them over for dinner. Call or text them regularly. Pay attention to changes in their mood and notice if they begin to talk about hopelessness, increased stress, or not feeling like themselves. Share your own struggles to normalize and validate their experience. Encourage them to seek professional help. Take them to appointments if you can or follow up with them afterwards to show you care.
Learn the warning signs and intervene when you see someone struggling. Websites like https://www.bethe1to.com/ and https://suicidepreventionlifeline.org/ are great resources. I also post mental health information @drwetegrove and on my blog. You can sign up for my weekly newsletter, too, for more information on suicide prevention and general mental health tips.
Support initiatives that provide funding and support to these groups specifically. Whether you contribute financially or volunteer your time, most organizations rely on public involvement. Organizations to consider include:
National Veterans Foundation: https://nvf.org/
The Wounded Warrior Project: https://www.woundedwarriorproject.org/
Farm Aid: https://www.farmaid.org/
Human Rights Campaign: https://www.hrc.org/
The Trevor Project: https://www.thetrevorproject.org/get-involved/
*I am not affiliated with any of these organizations and their listing here does not indicate my endorsement.*
Contact your local legislators and ask what they are doing to support these communities. Suicide is a public health crisis and it’s important to know where the people who represent you stand on this issue. I know that most of us are tired of the politicizing of EVERYTHING, however, legislators ultimately decide how our tax dollars should be spent. Getting mental health treatment into the lives of those who need it and expanding suicide prevention initiatives will save lives. Speaking up for vulnerable populations is up to us. Use https://www.usa.gov/elected-officials to identify your representatives and look up their contact information. Write or call them. Attend town halls when they are in your area.
Are there other at-risk populations you’re interested in learning about? Questions about suicide prevention? Let me know in the comments below.
We’ve all had something stirring inside of us at one time or another. That thing you’ve been dreaming about doing but can’t quite muster up the courage for. Maybe it’s running your first 5K or finally starting that side hustle. Maybe it’s speaking up for a promotion or sitting quietly long enough to start studying for the LSAT or writing a book. Maybe it’s creating a healthier life by improving food choices, ending toxic relationships, or carving out time for self-care. What is fear holding you back from starting?
Some people argue that it’s laziness and lack of motivation that keep us from acting. I disagree, because we spend an inordinate amount of time planning for the thing, spending valuable time, money, and resources. This takes motivation. It’s easier to dream safe by never taking the next step to see what will actually happen if you start training for the run or networking with potential customers or opening a study guide or putting your thoughts on paper so you can share them with an audience. We are paralyzed by what we think is going to happen. We think we will fail. When I decided I wanted to create a blog for women who were ready to make changes but didn’t have access to the information to do it, I spent so much time researching. How does one start a successful blog? What makes a successful blog? Who are successful bloggers? What are they writing about? Should I write about that instead? It felt safer to plan and analyze and consider repeating what was already proven to be successful, even though it wasn’t my dream. This is called analysis paralysis, and it will kill our dreams if we let it. Conquering my own fears of vulnerability has reinforced what my education and training taught me. That is, there are skills we can build to overcome fears. However, using the skills in my own life provided the first-hand experience necessary to speak power and truth into them.
Start small to start now.
We dream big dreams that can become overwhelming if we don’t break them down. The result is that we never build the momentum necessary to reach our goal. If you’ve never run a 5K, start by taking a short, brisk walk. If it’s overwhelming to think about studying for an hour at a time, start with 10 minutes instead. James Clear encourages building atomic habits, practices so small they might appear meaningless at first but, over time, build upon each other to result in large-scale behavioral changes. The answer to overcoming analysis paralysis (i.e. Should I download an app that helps me train for the 5K or print out a running plan or create my own plan based on my schedule?) is to start something, anything, now. Then, assess the outcome and adjust accordingly. Starting small allows us to achieve goals incrementally. These successes build mastery, which is proven to decrease depression. Mastery is that sweet spot between something that is so easy it doesn’t take any effort and something so difficult that we are guaranteed to fail and beat ourselves up in the process. Feeling good about our achievements reduces fears about accomplishing the next goal.
Do it often.
Before trying something new, our brain often predicts the worst possible outcome. One of our brain’s jobs is to keep us safe, and, when venturing out into the unknown, it doesn’t have enough data to make a good prediction. In psychology, exposure is the practice of facing the feared stimulus over and over again, until it loses its anxiety-provoking power. In exposure therapy, we start out small and incrementally build up towards the feared stimulus. For example, I sent my first blog to my most trusted confidante, and then to five close friends, and then to a friend-of-a-friend, all before making it live on my website. The idea is that, as exposure occurs, the data we receive back (whether that was receiving positive feedback on my writing, no feedback at all, or critical feedback) doesn’t have the catastrophic outcomes our brains predict. Consider what worst-case-scenario your brain is telling you will occur if you start working towards your dream. “I will fail.” “I will be the last finisher at the run.” “No one will like my writing and I will be rejected.” Engaging in the activity that you fear over and over and over again challenges these catastrophic thoughts our brains create.
Connect it to your values.
What’s your why? Being able to come back to this helps when we’re feeling unmotivated or don’t see the progress fast enough. Focusing on values rather than change keeps us steadfast when we aren’t seeing the growth we want fast enough. Values are our north stars, the beliefs that guide us. We never fully reach our values, but we set intentions that keep us moving towards them. These intentional actions are the small steps that, over time, will help us reach our goals. When fear comes knocking and we are able to face it by stating confidently, “I’m going to do this, even though I’m scared, because it moves me in the direction of the person I want to be,” you begin to conquer your fears. Additionally, reminding yourself of your why (“I’m exercising every day so I can play with my grandkids the next time they visit” or “I’m writing a book because I want to help others”) will eliminate some of the worries we have about what other people will think. Values overshadow embarrassment and doubt if we stay focused on them. Not sure what your values are? Here’s an assessment tool that can help.
Much like exposure, the more often we talk about our dreams with others, the less fear dominates us with each conversation. “I’m really nervous about taking the LSAT after being out of school for so long” or “I’m really scared that when I ask my boss for a raise, she’s going to say no” will likely lead to a validating response, like “I’ve been there” (unless you’re talking to a robot). We’re reminded that that fear is something everyone experiences when we talk about it. Our brain collects this data, and over time we are more likely to remind ourselves that everyone is experiencing the same fear we are. You are more likely to do it scared when you have shared your goals with someone. In fact, one study showed that 70% of participants were able to achieve their goals with accountability from a friend. You might be thinking, but what if I’m one of the 30% who still fails. I often encourage my clients to create a cope ahead plan, involving a friend or family member. For example, you might ask your sister to be available by phone or text immediately after you meet with your boss and ask her for a raise, in case she says no and you need to talk through your disappointment or embarrassment. You could find a running buddy and ask if they’d be willing to slow down their pace if you find you’re unable to keep up with them (this is a cope ahead plan that I’ve personally used). By carefully selecting friends and family members with a track record of supporting you in the past, you can reduce fears of shame, guilt, and rejection. If you haven’t felt supported before, they may not be the person you share your dreams with or involve in your cope ahead plan. Many people seek out support in the form of community or online groups with similar interests or they connect with a professional therapist for counseling or coaching. Lacking support from family and friends is a barrier that can be overcome with a little creativity.
So, you’ve done the thing. You’ve ran a 5K, written the first 100 pages of your book, secured your first client, scheduled a date to take the LSAT. Congratulations! Reviewing how it went gives you an opportunity to check the facts. I’m more interested in the emotional experience, at least at first. Was it as bad as you thought it would be? Did fear debilitate you? What about guilt, shame, or sadness? Did you experience any joy in the process? Are you excited about the next steps? When we are crippled by fear, it’s hard to feel any other emotions. But, each emotion serves a purpose when it’s justified. If I’m feeling happy and excited, I’m more motivated to continue towards my goal. Therefore, it’s helpful to pay attention to our whole emotional experience. On the other hand, rating the actual outcome against the outcome we predicted before we engaged in the activity often gives us information about exaggerated emotions that our brain hangs on to. The next time we think about trying something scary, we are reminded, “I experienced fear and still did it” or “I overcame a challenge before, and I can do it again.” In the chance that the outcome was not one you hoped for, you can use the information to revise your plan and prepare for unforeseen issues. If fear did keep you from your goal, don’t beat yourself up. After all, anxiety is the most common mental health problem for adult Americans. You are not alone. Problem solving might include enlisting the help of a Psychologist or other mental health professional.
Conquering our fears allows us to achieve more, but more importantly, it allows us to engage in a values-driven life versus an anxiety-driven one. Research shows that individuals who have a life driven by their personal values are more content and connected. They are happier and healthier. They contribute to their families and communities in meaningful ways. So, why not start working to conquer your fears today?