About the Hosts

Christy Wilkie provides therapy for children and adolescents, ages 5-25, who have complex behavioral health issues. She combines her extensive clinical expertise with a belief in kids, and has a unique ability to find and develop their strengths. She works hard to be an ideal therapist for her clients, doing what is best to fit their needs.

Lucas Mitzel provides therapy for children, adolescents, and adults, ages 5 - 30. He believes building relationships with clients is the most important piece of successful therapy. He loves what he does, because it allows him to walk next to people he would never have met had he chosen a different profession, as they work to make amazing life changes. He has the honor of meeting people at their worst, all while watching them grow into the people they’ve always wanted to be.

Transcript
Is Everybody Anxious?

Featuring Christy Wilkie, LCSW, and Lucas Mitzel, LCSW, Dakota Family Services

Announcer: 
This episode of, is It Just Me, is brought to you by Dakota Family Services, your trusted partner in mental and behavioral health, whether you need in-person or virtual care, the team of professionals at Dakota Family Services is dedicated to supporting children, adolescents, and adults in their journey to better mental health.

Christy Wilkie: 
Disrupting life patterns and life routines that aren't serving you.

Lucas Mitzel: 
It's how we feel that keeps us going.

Christy Wilkie: 
You can be a masterpiece and a work of art all at the same time.

Lucas Mitzel (00:00):

Hey everyone, I'm Lucas Mitzel.

Christy Wilkie: And I'm Christy Wilkie. And you're listening to the, is It Just Me podcast where we aim to provide education, decrease the stigma, and expel some myths around mental health.

Lucas Mitzel: Is it just me or is everybody anxious?

Christy Wilkie: Yes,. I feel like kind of.

Lucas Mitzel (00:16):

What, what even is that?

Christy Wilkie (00:18):

Anxiety? So I think it's just this constant feeling of worry. And not even that, but like not normal worry, worrying past what is even rational. It's an irrational form of worrying.

Lucas Mitzel (00:31):

Well, how do you even know that it's irrational? What does that mean?

Christy Wilkie (00:34):

 Well usually I give the example of like, there's people that will be anxious to go to school, right? Because just, there might be a test or whatever that's pretty normal to be anxious about. It's another thing to not wanna go to school because you're afraid that if you go into the school, you're gonna go into a classroom and if the teacher calls on you and you don't know the answer, that everybody is going to think that you are stupid and that you'll probably lose some friends and you'll probably get kicked out of class somehow and then you'll fail and probably not be able to go to college and get a job.

Lucas Mitzel (01:04): Yes. I had a client call those doom spirals.

Christy Wilkie (1:05): Yes.

Lucas Mitzel (1:06): And I'm in love with that phrase, <laugh>

Christy Wilkie (1:06): Stealing it.

Lucas Mitzel (1:07): Yeah, absolutely. And so those are very common when it comes to anxiety. And I have many examples personally of doom, spirals, <laugh>. But the classic symptom of anxiety is, is the excessive worry, especially in an irrational sense like you had had described. But there's also a lot of other symptoms that can go along with that, such as feeling restless. So like that's where you can't sit still or you're feeling like on edge all the time. Yeah. People who are anxious are tired very easily. And that is because when you're anxious, you're always prepared for something going wrong. And when you're always prepared for something going wrong, you are ready to spring into action, which means that your muscles are always tensed up, ready to go. Yeah. When you're flexing constantly, all day long, you're gonna be tired.

Christy Wilkie (01:55):

Yeah. I always tell people when they're like, I don't understand why I'm tired. It's like, well, when you're lifting weights Right. Your muscles will tell you when you've lifted too much weight. Like it's just, it will not work anymore. It will not go anymore. It tells you, your brain doesn't necessarily tell you or it does, but not in the way where it like shuts down, but in a way where you become really irritable and cranky. Yeah. And maybe not nice.

Lucas Mitzel (02:17):

Right. <laugh>. Yeah.

Christy Wilkie (02:19):

Tired because it's like, you have been working me all day long.

Lucas Mitzel (02:22):

Yeah. Common places where people will feel, uh, muscle tension is gonna be like in their face, their jaw, their shoulders and their back. And sometimes in the abdomen as well. And so people will describe having, um, like a sore jaw by the end of the day. Or they're just like really tense in their back and they're constantly getting like these knots in their back. And that's because that we're, we're just constantly flexing. And it's not like when we do workout, we can tell it really quick 'cause we're doing like these really big exercises. But you're just like gradually tensing more and more and you might notice it throughout the day and then relax your shoulders or things like that and get a break. But when you're doing that constantly right from the time you wake, wake up till the time you go to sleep, you're gonna be exhausted.

Christy Wilkie (03:01):

Right. Which is a somatic complaints are a very common thing that you find with anxiety. And I know I've, I've talked with a lot of parents specifically because they never know what to take seriously and what to not take seriously. 'cause like are they avoiding or are they really not feeling well? And odds are good that both are true <laugh>. Yeah. Because like stomach aches and literally feeling ill and nauseous and headaches when you're constantly carrying around worry, you have some of those and they are legitimate. Yeah. But I mean you also are trying to get outta something sometimes

Lucas Mitzel (03:28):

<laugh>. Absolutely. Yeah. And it's interesting 'cause like your brain can do some really weird stuff. I mean, our brain is very powerful. And so it picks up on patterns of things that have gotten you out of uncomfortable situations. And it'll try to mimic those things. some of my favorite examples of this are the more extreme ones. People getting migraines. for seemingly no reason, there's no real trigger until we figured out that it was anxiety. Right. I've had people who have hives or a rash that appears all over their body Yep. And nothing was helping it. They were doing all these different medical procedures and all these different medical things to figure it out. And once we figured out it was anxiety and treated it no more rashes. I had somebody else who was developing what seemed to be pink eye constantly. And they went to an optometrist, they go into doctors and there was never an actual infection. It was just the eye was pink and a little itchy. 'cause he was irritated. And once they treated the anxiety, it was no more. Yeah. So our brain and body is incredible.

Christy Wilkie (04:27):

It Is. And everybody responds differently and a lot of times people, people who have always been anxious don't understand that there's another way to be. Yeah. Like, you just think that everybody always feels like that. And so I, I think it's really important that we do a podcast on anxiety, I mean on all of these things. But for anxiety specifically, because I think because a normal level of worry is so common that it's, it's difficult to discern when your anxiety has gotten to the point where it's a clinical problem versus well, everybody gets anxious. So, you know, I'm no different than everybody else. And probably because the word anxiety is overused. That's a whole other podcast. Yeah. Yep. <laugh>. But there, when you have people who aren't clinically anxious, calling themselves anxious, then you have these other people who are super clinically anxious, who are like, well, everybody's anxious. Is it just me? Or is everybody anxious? Because it feels like they are without realizing that No, no, this is a different level.

Lucas Mitzel (05:21):

Yeah. People who are clinically anxious are anxious, like all the time for no reason even <laugh>, like Right. A lot of that's

Christy Wilkie (05:29):

 That’s whole that's, that's anxiety's whole gig Right. Is that there isn't a reason.

Lucas Mitzel (05:32):

I can't tell you how many times I've had somebody sit in my office and say, I have no reason to be anxious right now. Why do I feel like this? And anxiety just doesn't care. No. It's just gonna show up, sit on your couch in your head and just hang out. Right. And it doesn't matter that something didn't happen today. It's telling you something will.

Christy Wilkie (05:49):

Right. And the the tricky part is if you love somebody with anxiety or work with somebody with anxiety or are around anybody who has those thoughts, that's one of the most damaging things that you can ask is, well, what are you anxious about? Because they're scrounging in their head to be like, I don't know. And then it makes them feel worse. So it's like, you're right. I don't have any reason to be anxious. Like rationally speaking, there's not a thing that's making me feel like this. So they're like, well then just chill out. And I have tried, I've tried several times to tell my clients to just like, stop, chill out. You're fine. Right. And it's not worked.

Lucas Mitzel (06:23):

Just Stop it. <laugh>.

Christy Wilkie (06:24):

Yeah. Just, just quit worrying. Right. You're fine.

Lucas Mitzel (06:27):

Would you just relax? You're right. Yeah. It doesn't work.

Christy Wilkie (06:29):

It Has not, it hasn't yet. Yeah.

Lucas Mitzel (06:31):

It’s Just weird.

Christy Wilkie (06:31):

Think I'm taking that outta my toolbox. Yeah.

Lucas Mitzel (06:33):

Probably a good idea. Yeah, I think so. Yeah. Uh, <laugh>,

Christy Wilkie (06:36):

<laugh>. 'cause it's just, it's just there. It just exists. There doesn't have to be a trigger to it. Now if you're baseline anxious, there could be something that's making you more anxious that day. Yeah. If you have like a presentation or you have um, a performance review or you know, you have something where you have to perform anything that can take that already base level anxious and like, whew, shoot it through the roof. But typically speaking, the baseline anxiety is just, it just chills there. Yeah.

Lucas Mitzel (07:03):

Right. And for people who don't have anxiety, it's like you said, it's really hard to understand what this is like, but it's kind of like walking down a path that has a bunch of trees on both sides and you're walking down it and you are worried behind every single tree there might be a bear. And you could walk past a thousand trees and then the next tree has a bear. And your brain is like, I told you. Mm-Hmm. <affirmative>. This is why we're anxious. Right. And even though you did a thousand other trees and there's nothing there. Right. The one time it happens Yep. Now just solidified why we're anxious all of the time.

Christy Wilkie (07:36):

Well now you think everything is a bear. Yeah. That's what happens when you walk down the path and a bear comes out and your brain goes into fight or flight, which is really helpful when there's a bear. Right. <laugh>, you know, I mean it's thanks brain for looking out for us, but then once you get to that point, like anxious people kind of live in that state all of the time. Or I always tell people what it feels like when you've misplaced your keys or your phone Mm. And you're like, oh my gosh, I have no idea where my keys are. And this like moment of what am I gonna do? Like that's how anxious people live all of the time. So they're, they're always looking for the bear. Right. They think everything can be the bear.

Lucas Mitzel (08:11):

Yeah. And people who are anxious especially have been anxious for like most of their lives. That's just normal life for them. Right. Like if you were to tell them that what they're experiencing isn't normal, they, they have no idea. They think everybody feels that way all of the time. Right. And so a lot of times people won't go get help until it's like crippling. Right. And now it's impacting their everyday life to the point where they can't go to work or they can't be successful in what they're doing. But like when people start getting treatment for this and all of a sudden they feel better. Like, I could have done this 10 years ago.

Christy Wilkie (08:40):

I know. I'm sure this happens too all the time too. Most people are more likely to get help for their kids than for themselves. And so they'll come in with their kids and I'll describe to them what anxiety is, what it means to feel anxious, what the options are for treatment, all of that. And you can just see as I'm talking about the symptoms of anxiety, the parent is going, oh, oh no. Oh, am I, and then almost all the time they're like, I think that I'm anxious. I'm like, you probably are. There's a genetic component. So it wouldn't surprise me if you were also anxious. This generation is much better about getting therapy. Yeah. By and large. Because I feel like this generation of parents are like, I wanna make sure that my kids don't have to go through what I went through. And so in doing that, we end up kind of treating both of them and they're like, I just don't want my kid to ever feel like I felt, but I didn't realize that I could get help too. Right. It's like, well yeah you can. It's never too late. <laugh>.

Lucas Mitzel (09:34):

Yeah.

Christy Wilkie (09:34):

It's never too late to not be anxious all of the time. We get a lot of parents who just kind of have this like realization moment that it's like, oh my gosh, me too.

Lucas Mitzel (09:42):

Right. I don't have to feel like this. Yeah.

Christy Wilkie (09:45):

It's wild.

Lucas Mitzel (09:46):

And I think when it comes to anxiety, especially when it comes with kids, a lot of times it gets missed because it comes out as being irritable. or, uh, angry aggressive, angry. Yep. And if we can just treat that anxiety or the things that they're worried about or have them talk through some of those things, all of a sudden they're just not irritable anymore. But when you're on edge all of the time and then one minor inconvenience happens, you're gonna snap because you're already at the end of your rope. Right.

Christy Wilkie (10:10):

I think the other thing I see a lot with kids with anxiety <laugh> is that they lie.

Lucas Mitzel (10:15):

Yeah. <laugh>,

Christy Wilkie (10:16):

They, they lie a lot because they tend to be people pleasers. They don't wanna be in trouble. And so they will try to do anything to avoid a consequence or to avoid going somewhere or doing something that's gonna make them anxious. So they'll sometimes lie <laugh>. It drives parents nuts. Absolutely. And I totally get it, but once you can treat the anxiety that lying tends to go away.

Lucas Mitzel (10:35):

I think one of the most noticeable symptoms of anxiety, especially in kids, this is one of my favorite telltale signs, is how they sleep. Because when you're anxious, a lot of times it's really hard to fall asleep because for some reason that's when our mind decides to wake up and our anxiety's like, I'm gonna tell you all of the things that are gonna go wrong.  Tomorrow. Or the things that you did wrong when you were five years old. <laugh>. Right. <laugh>. Hey, do you remember this one thing that nobody else remembers? Yeah. So I went horribly wrong and you were super embarrassed. Yeah. I'm gonna, we're gonna think about it again. Of course. Yeah. <laugh>. So it's really hard to go to sleep when that stuff's going on. Also, a lot of people will wake up in the middle of the night and just be in a panic and nothing happened. Right. You just woke up and you're anxious. And then other times it's really hard to get up in the morning because of that avoidance that you're talking about. Like, I don't want to go to school 'cause things are gonna go bad. Yeah.

Christy Wilkie (11:22):

I mean you talk about going to sleep, I always explain anxiety. It's like, you know, most people like a car Right. Or a plane. It starts off slow and then you kind of slowly gain altitude and then you chill for a little while and then you kind of bring the plane back down again. People who are anxious, it's like a rocket. They just go straight up into the sky and they just keep going. And then we're trying to get them to sleep when their plane is like literally skyrocketing. And it's like, we gotta figure out how to land your plane at nighttime. Like what steps can we take to like slowly bring you back down to a place where you feel like you're safe and comfortable and in control of the space. Because anxiety's all about control and help you with your sleep in that way.

Lucas Mitzel (12:02):

Yeah, The control thing is huge. Yes. And I see that all the time. Kids who are anxious, parents who are anxious. They are always trying to get more control of things. And so kids will like pick fights over things that don't make any sense. to us about like whether or not they wear pants., right? Yeah. And it's all about just controlling their environment because they feel outta control. And a way to combat that is to give them different options. instead, two options that we both want uh, do you wanna wear the blue pants or the red pants? >. And as long as they're wearing pants, we don't really care. Right. So by giving them some, what I call pseudo control over their situation, they're gonna have a little bit more compliance that way.

Christy Wilkie (12:40):

Um. Right. And the more control you have over a situation, the less likely it is that anything is going to come from the outside that you're not expecting. 'cause that's the bear. Right? Yep. Something could happen that I'm not expecting, but if I'm in control of a situation, then nothing bad is gonna happen. If we play the game that I wanna play and it goes the way that I want it to go, then everything goes fine. And so anxious people can look a little bossy. And I think one of the other things that people often overlook is having control in conversation where they'll monopolize the conversation because if they're running the conversation, then they don't have to worry about what's coming out of somebody else's mouth. They're controlling the topic, they're controlling who's speaking. So it kind of comes off as they're monopolizing conversation and they are. Right. But because they're trying to manage their anxiety in a way that works out.

Lucas Mitzel (13:27):

There's a reason. Yeah. Always. Yeah. So we started talking about this a little bit, but what are some things not to do? <laugh>, when somebody's being anxious? <laugh>,

Christy Wilkie (13:35):

The first thing that comes to mind is if you know that you are dealing with someone who is anxious, do not text them, call me. Don't do that because they ever assuming that they are either in trouble, that somebody is dying or that something terrible has happened and that they have to prepare their whole day. And when you create that spike, and I'm not even joking, like it sounds, it sounds so silly, but when you create that spike in anxiety, it takes the rest of the day for that anxiety to even come back down to where it's manageable. Yeah. Because you've already shot it up. Just be like, Hey, everything is okay. You don't have to worry. I just would like to talk to you about having dinner on Saturday. Like we want context, all of the information. Yes. Like give me all of the information. Yep. That is the first thing that always comes to mind is communicating with somebody who's anxious in a way that has all of the details in one text.

Lucas Mitzel (14:22):

Yes. Um, or

Christy Wilkie (14:23):

Voicemail.

Lucas Mitzel (14:24):

Yeah. Or voicemail, whatever. Like if my boss were to be like, we need to talk.

Christy Wilkie (14:28):

You're getting fired.

Lucas Mitzel (14:29):

Absolutely. I'm getting fired. And so if you're listening, please don't do that. <laugh> <laugh>, the context matters and giving that extra information just helps them feel better. Yeah. It helps me feel better. Right. So another thing to not do is when somebody is in a doom spiral, don't try to be logical or like challenge their thoughts in that moment. They're not hearing you. No. Their fight or flight response kicked in and they can't process that information. Right. It's going to be really important to just focus on calming down first and then we can access that part of the brain. You would have better luck talking to a brick wall. At that point.

Christy Wilkie (15:06):

It's trying to have a rational conversation with an irrational person. And we talk about this with depression, we talk about this with suicide, we talk about it with all those things where they just need you to be there and listen and support them. This is not the time to do any sort of like fixing it <laugh>.

Lucas Mitzel (15:23): Right.

Christy Wilkie (15:24):We're not trying to fix it. You're just there to help them, like go through the spike because nine times outta 10, they know that it's not rational.

Lucas Mitzel (15:30):Oh yeah.

Christy Wilkie (15:31): But it's like you can't stop it. It's just there. But don't make fun of them for that. Like

Lucas Mitzel (15:35):Yeah.

Christy Wilkie (15:36):That I think happens a lot. I mean, I <laugh> the risk of self-disclosure, but here we go. <laugh>.

Lucas Mitzel (15:37):Oh boy.

Christy Wilkie (15:37):But I am an anxious person. We know this. I always tell this story because this is how irrational is. And I'm a fairly well put together person.

Lucas Mitzel  (15:47):Fairly.

Christy Wilkie (15:48): Fairly.

Lucas Mitzel  (15:48):Yeah.

Christy Wilkie (15:48): Most days.

Lucas Mitzel (15:49): I'll give you that.

Christy Wilkie (15:19 ):Yeah. So one day I was packing to go to a trip to Bismarck and I had my flat iron that I had just used. So it was warm, put it in my bag, packed it, it hadn't totally cooled off. I had it in my suitcase and I left to go to work. I was gonna come back and grab it and leave. And I got out of my driveway and I was like, okay, well that flat iron is going to catch on fire.

Christy Wilkie (16:11):Oh my God.

Christy Wilkie (16:12): And then it's going to set my suitcase on fire, and then my house is gonna be on fire. And then I'm gonna have to deal with all these insurance people and along with finding a new house because my house is burnt down. And so in that moment, and this is how I've learned to manage my anxiety, I can either challenge my cognitive distortion, right? I can be like, Christie, like, come on girl, you know better. Or I could go back and just get the dang suitcase. So if I see it, I know that it's not blown up. And in my head I was like, if I put that suitcase in my car, it's way easier to just replace my car than it's replace my house. Right. <laugh>. So that's these. So of course I went back and I got it.

Christy Wilkie (16:46): Of course.

Christy Wilkie (16:47): And it was just like, it was the easiest way in that moment with the timeframe I was in to manage that. And I can laugh about it myself, but it's a real fear. It was a real thing that I was thinking. The fact that my brain went down that pathway, I was like, oh gosh. I mean we're not in a good space, but we're gonna go get the suitcase. Yeah. Because <laugh>, that's what it's gonna fix it. But when do you tell, when I tell the story, everyone's like, oh my gosh, that's hilarious. It is in retrospect. But in that moment, if somebody would've been like, you're an idiot, I would've been like, no, you don't understand. Like this is a real fear that I'm having. And so if somebody just would've been like, okay Christy, what are your options? You can either challenge the distortion and work through it or you can just go get the suitcase. Like sometimes you need someone to just be like, okay, what are your options? Help me through that.

Lucas Mitzel (17:29): Yeah. Because you just need to get through that moment. And then when you are through the moment, then you can work on that moment.

Christy Wilkie (17:34):

Totally. Yep.

Lucas Mitzel (17:35):

So if you're in a heightened state, you're not gonna be able to process through that very well. No. So we just gotta get you through that part and then we can work on that. And then hopefully by working on it, you are able to then challenge it next time. Right. Because you already have this script in your head and you've already worked through that.

Christy Wilkie (17:50):

Right. Another don't do is to ask somebody to perform a high level task when they're anxious.

Lucas Mitzel (17:56):

Oh god. Yeah.

Christy Wilkie (17:57):

Mm-Hmm. <affirmative>. Because that is difficult and, and not even a high level task. It can just be like a medium task <laugh> task.

Lucas Mitzel (18:04):

Any task.

Christy Wilkie (18:05):

Any task At all. I mean, I have had so many people that have come in and they're like, I lost my keys. And they're so anxious and they're literally right in front of them. But when you are in that heightened state of arousal, you cannot see what is right in front of your face.

Christy Wilkie (18:18): Yeah, absolutely.

Christy Wilkie (18:19): So it's like you have to take time and calm down and you hear it all the time where people like it just came outta nowhere. I looked everywhere for it. And then there it was right on the counter. And it's like, because your brain was overloaded and you aren't able to perform that way when you're in a heightened state of arousal.

Lucas Mitzel (18:32): Yeah. You just can't function. I mean your prefrontal cortex is shutting off, which is the place in your brain where you have rational thought and you are processing through things. Yeah. And making rational decisions. So when that's shut off because your amygdala's firing or whatever Mm-Hmm. <affirmative>, you're not gonna be able to make those rational decisions very easily. At least.

Christy Wilkie (18:48):

No. I always liken it to, if we take whatever your worst subject in school is, mine is math.

Lucas Mitzel (18:54):

Math. <laugh>. Ah.

Christy Wilkie (18:55):

This is why we work with people. 'cause we don't do numbers <laugh>, but it's like, we'll just say spiders. 'cause spiders are a relatively unliked thing. It's like putting somebody in a room full of spiders and asking them to do calculus. That's kind of like what it's like to ask an anxious person to do anything when they're in a state of, of arousal. Like

Lucas Mitzel (19:16):

Absolutely. Yeah.

Christy Wilkie (19:17):

You think you're gonna do meaningful calculus when you're covered in spiders? Probably not.

Lucas Mitzel (19:22):

No. I, I mean I can't do a calculus if I'm sitting on a cloud. That's

Christy Wilkie (19:25):

Fair. I sometimes can't even say the word calculus, but

Lucas Mitzel (19:28):

Fair enough. Here we are.

Christy Wilkie (19:29):

Yeah. <laugh>. So just don't ask them to do something that they're clearly anxious and it's like, okay, I get you're anxious, but go clean your room. Nope.

Lucas Mitzel (19:37):

Yeah, absolutely. I hope that this is common sense, but I'm gonna say it anyways because for some people it's not saying things like, calm down. it's not a big deal. Or just relax are some of the most invalidating things that you can say to somebody. And it's just gonna make them more anxious. And now they're anxious about being anxious because now they feel dumb.

Christy Wilkie (19:53):

Right. And they're now they're worried about what you're thinking about them. Yep. Because they think that they're bad because you've used that. Don't stop. Can't words. Yes. And it's like, oh my gosh. Then it completely invalidates their experience.

Lucas Mitzel (20:03):

Yeah. Which kind of brings me to what is the difference between like anxiety and then a panic attack?

Christy Wilkie (20:10):

It's a great question. I think people sometimes go through panic attacks and they don't realize that that's what they are. Yeah. But panic attacks are very intense moments of intense worry and anxiety to the point where you have tunnel vision, you get sweaty. It almost feels like you're not even in your body a little bit. A lot of people will go to the ER when they have panic attacks because it very much resembles a heart attack. Yep. Where your breathing gets really shallow and you cannot get control of it. Like you just can't.

Lucas Mitzel (20:40):

Yeah. A lot of people will need to like sit down on the ground and that's just a natural response that a lot of people do, but they're actually trying to ground themselves and they don't even realize that they're doing that. Right. And it's really, really important that when you have somebody that you love or somebody that you see is going through a panic attack, that you are just focusing on calming them down. And that is not by being rational with them. We are breathing, we're just trying to relax the body because their brain is literally turned off. Yeah.

Christy Wilkie (21:08):

It's more of a co-regulation role. Yes. Where it's like, okay, breathe with them. And we talk about breathing a lot and how many times have you told kids we gotta work on deep breathing and they roll their eyeballs outside of their head, out of their ears every time. Right. Because I don't know that anybody really explains to people what deep breathing does, but most anxious people without even realizing it, are relatively shallow breathers. They're not taking breaths in and out like most people do. Like full breaths in and out. It's just a more shallow breathing. And so you think about what does your breathing do when you're getting followed or when you feel like you're in danger, you get shallow breathing. Yep. Right. And then when there is like an actual thing that's right there, oh my gosh. Like your breathing gets super shallow. So the act of like deep breathing is to remind yourself and your brain that you're not in a situation where you're gonna die.

Christy Wilkie (21:56):

Which sounds so like drama, but <laugh> like so dramatic.

Lucas Mitzel (21:59): For real.

Christy Wilkie (22:00): But it's not. But it is. It's absolutely true. And so if you can get in control of your breathing, your breathing tells your brain that you're okay, that there's nothing here that's gonna hurt you, but this, whenever you have this shallow breathing, your brain is always in this fight or flight mode all of the time thinking there is danger here. And so if you can get people to deep breathe, especially in a panic attack, it's finding a way to tell your brain at the very primitive level that you're okay.

Lucas Mitzel (22:25):

Yeah. I always like to compare it to basically like hacking your brain. You're just doing it in reverse. So what we try to do is have our brain calm our body down by, you know, challenging our thoughts or thinking differently or whatever. But you can also have your brain think differently by calming your body down. And you can actually simulate this right now if you'd like to by taking a second and just breathing really shallow, really fast. You're going to start feeling maybe some different emotional responses or some even just physiological responses by doing that. And then once you do that for a minute and you start to feel that change, switch it to really deep breathing where you're breathing in and then you breathe out longer than the inhale and you're gonna start feeling that calming sensation. That's what you're shooting for. Yeah. With the deep breathing, there's a million different ways. Yeah, yeah. Whatever. There's so many, there's so many breathing techniques that people say, this is the right way. Do what works for you. And if you like having the numbers or whatever, that's fine. The most important thing about deep breathing is that your exhale is longer than your inhale as long as you're doing that, whatever numbers you're using, it doesn't really matter.

Christy Wilkie (23:29):

Right and a lot of people do square breathing where it's in for four, hold it for four and then out for four and then hold it when you're exasperated for four. That's a big one for kids. They do a lot of like blow on the cookie, like, cool the cookie down or blow out your birthday candles or blow up a balloon like a fake balloon. 'cause it's just those little kids get really excited about that. It's just kind of a way to get them to think about it differently. So it's not like take deep breaths, <laugh>. Yeah. It's like blow up the, blow out the candle. That's way more fun.

Lucas Mitzel (23:55):

Yep. I've used the Holman spheres, whatever, the retractable spheres. And I've used that as a visual, like when you breathe in it gets really big and then we breathe out, it gets small again. And then having them mimic that of what they're seeing and even making it a competition with kids especially that really, it essentially tricks them into practicing deep breathing. Yeah. Which is great.

Christy Wilkie (24:14):

That is, it's fantastic.

Lucas Mitzel (24:16):

And so another thing that you can do for people who are anxious, especially if you yourself are anxious, this is a really good strategy to use to prevent anxiety or to keep it lower, is by practicing something called mindfulness, which would give, we could probably have our own whole podcast episode on mindfulness.

Christy Wilkie (24:35): That's true. Yes.

Lucas Mitzel (24:36): But mindfulness basically is just focusing on the moment without judgment. You're really just being really present in this moment and you're doing that on purpose. So an example of this could be you are taking an object and you were describing it to yourself in as much detail as possible. When you do this, you are forcing your brain to think about something else. it kicks all those negative thoughts out and it allows you to then calm down when you are anxious, you're typically thinking about the future.

Lucas Mitzel (25:03):

Whether that be something that's going wrong or whatever. Sometimes people get anxious about thinking about the past. Oftentimes I would say that when you're doing that, it's because you're worried about the consequences that are gonna happen because of that past event. in the future. So it's typically about the future. regardless, you're not thinking about right now. Right. So if you can use mindfulness or any sort of activity to get you to think about right here, right now. you are going to calm down. Yeah. Because typically right now in this very exact moment, things are okay.

Christy Wilkie (25:33):

Right. One of the things that I do a lot with people, to get them to have an idea of what that feels like is to have them start at their toes and go all the way up to their head to be like, feel what your feet feel like in your socks and what your socks feel like in your shoes. And the pressure that your shoes are putting on your feet. Yeah. And then moving all the way up because you don't think about that. But if you're forced your brain to think about what is your body feeling and checking in with it and then you're in the moment, you're out of your head, out of those thoughts and you can get, by the time you get to the top of your head, most of the time people feel a lot better.

Lucas Mitzel (26:04):

Yeah. That's called a body scan. And they're super helpful. You don't have to do them by yourselves. You can just like YouTube stuff or Google something and they have guided ones for you all over the place. There's a lot of really awesome apps like Headspace, I think Calm is another one. There's some other ones out there too. Yeah. They're all excellent and they're really, really helpful. There's a lot of different versions of mindfulness. There's a million different ways that you can do mindfulness all the way from A body scan to, I mean going phishing Yeah. Can be a mind activity for sure. So doing a puzzle or doing any sort of art or trying to create something of some kind can be a mindful activity playing Minecraft. can be a mindful activity. So

Christy Wilkie (26:43):

Playing Candy Crush.

Lucas Mitzel (26:44):

Yes. Thank You

Christy Wilkie (26:45):

Yep. Absolutely. We talk a lot too about progressive muscle relaxation and I only throw that out there because if you put that into YouTube or Spotify, there's a million of them that come up and they're free. You just have to find someone's voice who's not annoying. Yes. Which is literally the hardest thing for me. I just need someone whose voice I don't hate. But it's literally going again from your toes to your head where you're flexing and letting go, flexing and letting go of all your muscles from your toes to your head. They walk you through it and most of the time, even people who aren't anxious honestly don't realize how tense you are all of the time without even realizing it. 'cause by the time you're done, you're like, oh my gosh, I did not realize that I was carrying all that around. Absolutely. It's a lot of work.

Lucas Mitzel (27:27):

It's <laugh>. Yeah. <laugh> and progressive muscle relaxation is very similar to if you've ever gotten a massage, it is putting pressure, uh, on the muscles like a massage or flexing those muscles. And then when you release the tension it relaxes the muscle, which then starts relaxing the body, which then relaxes the brain. So it's very, very similar to that. And if you've never gotten a massage, I highly recommend it because they're amazing. And they, it's a very mindful activity as well. It is. So we've already talked about, uh, paced breathing and progressive muscle relaxation, which always makes me think of the DBT skills for tip. And so we're only missing two of them, which is, the first one is temperature. Some people also call that ice diving. And that's where you fill up a bucket or a bowl of water just as long as the bowl can fit your face in it <laugh>.

Lucas Mitzel (28:09):

And the water just needs to be a little bit colder than room temperature. And all you do is you take a deep breath and then you put your face into it, up to your temples and you just hold it there. As long as you can come back up, breathe again, and you go back down. by doing this, you're gonna activate your parasympathetic nervous system. and force your body to start regulating itself, which includes not only just the temperature, but your emotions and your heightened arousal.. And it works like really fast when you do this. You can also use a cold shower to do this. Some people also really like to use ice packs. You can do that if you're doing something where you're not plunging your face into a bowl, you just need to make sure that you were holding your breath because that's, thank you. That's the key.

Christy Wilkie (28:49):

Yeah. That, that's important. And just you threw out DBT, that's dialectic behavioral therapy, which is another modality that we're trained in and use when we're helping people figure out ways to manage the stuff that's going on inside.

Lucas Mitzel (29:01):

Yes. The last one in tip that we haven't covered is intense exercise where essentially the idea with this is that when you're really, really heightened, if you get your heart rate skyrocketing really fast, it makes your body be like, hold on, this is way too much. And then it grabs onto it and tries to make it calm down. And the only downside to intense exercise is that you get sweaty. And for some people it can take the longest out of all the four skills we just talked about, but it is also a very good one to do just even proactively. So that you are regulating your body and your anxiety overall.

Christy Wilkie (29:36):

Right. You've used this proactive term twice today that I can remember. Maybe you did more, but in general, we tend to wait until something is a problem before we address it. And by the time it's already a problem, you're looking at figuring out how to come back down from that than you are preventing it from happening. So people who are anxious start the day at a higher arousal level than most people. And so they don't have much farther to go until they're at a place where they're super, super distressed. Where people who are not anxious start at like a baseline level that's relatively tolerable. So they can usually manage more distressing situations before they would ever get to the point where they lose it. So the goal with a lot of people with anxiety is like prescribed breaks where it's like you don't have to wait until you're anxious to do a deep breathing exercise or to do a progressive muscle relaxation or to do a grounding exercise. Like let's do it beforehand. Because when they start creeping up, sometimes you don't realize it. And so we wanna keep it down as much as we possibly can. So taking those prescriptive breaks before you start to feel like you're not able to come back from where you are so important.

Lucas Mitzel (30:39):

Yeah. Like you said, it's like a rocket ship. And I'll describe it as exponential growth, where at a certain point, which is like the only math term I probably know <laugh>, I was,

Christy Wilkie (30:48):

I was curious why we went there.

Lucas Mitzel (30:49):

I know because it works <laugh> and with exponential growth, like there's a certain point where it's basically you're just going straight up and so it'll start off really slow and you're just like, ah, I'm just a little anxious, it's fine. And then all of a sudden it gets a little bigger and you're like, yeah, that's bothering me, but it's not too bad. And then it hits a spot and then you just go off the charts. Really quickly. So I always tell people that on a scale like one to 10, if you're feeling it and you notice it at a one, two or three, like let's do something about it. Yeah. At a four, five and six, we need to stop and make sure it's getting taken care of. Seven and up. We waited way too long. Yeah. And now we're using emergency coping skills. Right. And we can't function. So we, we want to avoid that because the higher up it goes, the harder it is to pull back down.

Christy Wilkie (31:29):

Yep. We talk about that too. Even in schools, how to work some breaks in for kids that need breaks even when it doesn't look like they need it to be like, you know what? We're just gonna say at nine 11 and two, we're taking a 15 minute break because I think it's gonna be better for everybody if we can get their baseline down and practice some mindfulness or just go play a game or do something that is fun and enjoyable to just kind of reset them a little bit back to where they is at least tolerable.

Lucas Mitzel (31:52):

Yeah. So then what are some warning signs that kids that you work with are anxious?

Christy Wilkie (31:57):

Yeah. Complaining about stomach aches. Yeah. That's a huge one. Huge restlessness. Like psychomotor restlessness where they're like shaking their leg or they're, you know, fidgeting,

Lucas Mitzel (32:06):

Fidget.

Christy Wilkie (32:07):

Yes. Thank you. I got you. Where they're, where they're fidgeting. I have so many clients that come in and I can tell exactly where they are based on how long their fingernails are. 'cause they're biting their fingernails or they're biting their lip. Just all sorts of those things.

Lucas Mitzel (32:18):

People who are, especially kids are really anxious. They, they get stuck on subjects and they might repeat themselves over and over and over. Or they might keep bringing up a thing that happened today and that's because it's on their mind. Mm-Hmm. And they can't keep it in anymore and they just have to keep getting it out. they might be really struggling to do something. So like people who might get, get anxious, you might see them like, kinda like frozen call it like anxiety paralysis or like they can't make a decision or they seem like they're just like frantic or like almost panicking. Yeah. These are all signs that maybe we went a little bit too long and didn't do something about it.

Christy Wilkie (32:53):

Right avoiding situations that they normally are excited about. I see a lot of kids when their general anxiety is higher, that they are more clingy to their parent <laugh>. Yeah. Because their, their parent is their co-regulation and as long as a parent is there, they feel like nothing can hurt them. And so they'll kind of go through these clingy phases and it's not that they're being clingy, it's that they literally feel like they need to have you there or something bad is going to happen.

Lucas Mitzel (33:16):

Yeah. And that kind of goes into a little bit of like separation anxiety too. Yeah. And with separation anxiety, it's exactly what it sounds like. There's anxiety when it comes to separation from a caregiver, but it's even bigger than that for a lot of kids. Like they're worried that you're going to die. They're worried that they are going to die. Or that one of the most popular things that kids are scared of with separation anxiety is that somebody's gonna break into their house in the middle of the night and take them or like kill their whole family. And they don't talk about it <laugh>. They, they don't, they just act out. But as soon as you're like, do you worry that your parents are gonna die or something, then they're like, yes. Yep. That's it. Yep. That's the one. <laugh>. And it's separation anxiety is really hard for families to go through because it can be really frustrating, like when you're doing drop offs and they just will not go into the building or every single time you separate, there's a big tantrum involved when you do drop them off and you leave, they're better within 30 seconds. Right. Uh, it's just that initial drop off point. So parents, if you're going through that, uh, number one, I would encourage you to seek a professional to help you through that because this is very fixable. Yeah. But number two, just leave.

Christy Wilkie (34:24):

Yeah. And there are like super severe kids work with the school and come up with the plan because the school wants them to not be doing what they're doing as much as you do. And so if he or she, if they have a friend that they can walk in with, or if they have a teacher Yeah. That they're comfortable with, like trying to find ways to make that entrance into the school easier for them and easier for you. Because those are some pretty easy fixes that most schools are really willing to do. And pre-teaching. Holy man. Pre-teaching will save your soul. <laugh>. Yes. I swear. We'll have kids go and practice walking into the school or going to see the school, walking through the school before the school year starts, or anything that you can do to pre-teach what the expectations are, ask if they have any questions and manage that sort of thing.

Christy Wilkie (35:08):

Because it, it does feel not good to walk away from your kid when they're having a tantrum. But if you've gone through all the pre-teaching and they knew that this was the thing and they're, and they're like, I know that you're gonna have a hard time, but I'm gonna go and I have faith that the school's gonna take care of you. Like, there's a whole thing around that so that they're not traumatized. You don't feel like you're like abandoning your kid. But I spend a good deal of time in September talking about <laugh> school drop offs. 'cause they're so hard. Hard every year. Every year they're so hard. And it's so tricky as a parent, right. Because the second that you allow that tantrum to be like, okay, I'm taking you out, you're reinforcing the behavior. So now they know that that's how they can get outta going to school.

Christy Wilkie (35:45):

And at the same time you have this like, oh my gosh, I don't wanna leave my kid when they're crying and having a tantrum and a lot of times ripping their clothes off. That's a thing that kids do. It is very common. Because if they're doing that, then they know that they won't let them into school and they'll just keep upping the ante <laugh>. Until they realize, you know what, no matter what I do, I still am gonna end up in school. But I would encourage you to work with a therapist and they, they'll work with the school. And the schools, at least in Fargo are, have been really great to work with when we're trying to get kids into the building. Because again, it's, it sounds so dramatic, but they literally think that if you leave them that you are going to die. And so put yourself in those shoes, you know, where you're, and we're adults with a fully formed brain for the most part. And the idea of, if I truly believed that if I left somebody that I loved that they were going to die, I would wanna keep 'em around too.

Lucas Mitzel (36:35): Oh, absolutely.

Christy Wilkie (36:36): If they're in, if they're in my line of sight, then I know that they're not dead <laugh>. Yeah. It's a very real fear that they really do think that this is gonna be the last time they ever see you.

Lucas Mitzel (36:45):

Yeah. I will just also say that with these sorts of things, sometimes it's not consistent. So like they might be really struggling when it comes to drop offs at daycare or drop offs at the school, but then like if you were to leave them with a grandparent or something like that, they're fine. And that's because anxiety's not rational. So it's not going to necessarily be consistent in all across all areas and why it happens that way. Nobody really knows and it doesn't really matter necessarily. Right. But it's just keeping that in mind that this is a little bit more complicated than just a blanket statement of every time you separate. And it's just, it's, I just wanna keep emphasizing like, this is very fixable. It is. This is super doable.

Christy Wilkie (37:22): I think the big thing about the separation anxiety too is like if the kid knows that they're going to a place and they know exactly what's gonna happen, there's nothing that's gonna come out that's gonna be unpredictable. Right. So like going to grandma's house, that's fun. They know grandma and grandpa, they love grandma and grandpa. They know that grandma and grandpa aren't gonna make them do math. Right. You know, <laugh>. Exactly. They know that it's a pretty safe space. And so yeah, that's a pretty easy thing at school. I keep going back to this, but one of the big things is like, they get called on and they don't know an answer one time and then all of a sudden you're gonna have a, a separation anxiety issue. 'cause then that's no longer a safe space. Now it's not predictable. That's not a predictable place for them to be.

Christy Wilkie (38:00): And once something becomes unpredictable, it becomes scary. And then we have to try to find a way to get control over it. And that's fight or flight. And so they'll try to avoid it. And a lot of people don't think of avoidance as flight, but that's what it is. How can I avoid this, this unpredictable situation? I have some really anxious kids that just need someone to walk through them with them once. So like a hot lunch line. I spend a lot of time talking about hot lunch too, because that's stressful and there's places to sit and how are we gonna get there and what are we gonna Yeah. Deal and carrying deal your tray. Like it's a huge thing. So if they can have an adult that they like walk through that unknown thing with them, then it becomes known then it's not scary anymore. But we see this a lot at the change of a semester when their schedule changes and they and their or their teachers change, all of a sudden there's like this spike in anxiety and it's because well now it's not a safe space anymore. Yeah. It's not predictable. It's not a predictable place to be. And so yeah. It, it can look like it's out of nowhere, but it wasn't.

Lucas Mitzel (38:55):

Yeah. Typically something happened and it doesn't even need to make perfect sense as to how that's connected, but for them it does  going back to a little bit, people breaking in. I have had this conversation I feel like a million times with kids, and this is also a really good example of how to help somebody who's really anxious kind of challenge those thoughts if they're in a space to do so. Mm-Hmm. <affirmative>, I would never do this with somebody who's like right now heightened because again, we calm down first and then we talk through it. Yes. So one of my favorite activities to do with kids regarding this is to have them pretend to be the person breaking in. And tell me how they would do it. because they know all the secrets of the house. They know all of the doors and whatever.

Lucas Mitzel (39:33):

So they start telling me like, well, I just go through the front door. And then I'm like, well, don't you lock your door at night. like, well, yeah. Okay, so you can't get in there, try again. And then we just keep going through those things and I'm like, okay, well what if you did break down the door? What would happen? Well, my dog would start barking. Oh, okay. So then what's gonna happen? Well, my parents will wake up, then what's gonna happen? Well then they'll call the police and then they'll get caught. I'm like, okay, so you're probably not gonna do that, are you? Okay? Yeah. So now we just keep going through that and showing them by asking them questions and making them come to the realizations themselves that they're safe. And by doing that, it convinces them much easier than us just saying, you're safe. Relax.

Christy Wilkie (40:10):

Right. Another thing, parents of anxious kids have a hard time figuring out what's hovering and what's like helping. And the thing is, it may seem hovering for a while, but that's what they need. Yeah. So you, you have to meet an anxious kid where they're at. Otherwise they can't get there on their own in their head. So we'll have parents walk through the house and be like, we're gonna lock this door. We're gonna lock these windows. Show them that everything is locked. 'cause sometimes a walkthrough <laugh> to, to like assure them that we've locked all the doors we have, you know, whatever you have in place for security measures or whatever. And even if you do that sometimes for just a week, that's enough for kids to be like, okay, I trust it now I I know that you're locking all the doors. Okay. I get it. And that sometimes is all it takes. But not being afraid or feeling like you're giving into something <laugh> I guess when that's something that your child needs to feel secure in their house. Like Yeah. 15 minutes at night's gonna help everybody sleep well, let's do it.

Lucas Mitzel (41:03):

Yep. Exactly. I think that goes into a little bit of, 'cause one of the big things that people like to do with anxiety is do exposure work. And that's where you expose somebody to the thing that they're anxious about. >. And you essentially make them confront it. So if I'm scared of heights, it would be exposing me to heights to show me that it's fine.

Christy Wilkie (41:20):

Hypothetically.

Lucas Mitzel (41:20):

Hypothetically. Yeah. That's never happened before <laugh>. Um, but it's really, really important that if you're doing something like this, that you're doing this under the instruction of somebody who knows what they're doing. because you can easily make things way worse by doing exposure therapy. Wrong. it's a very delicate process. And so if you have a child and you are wanting them to experience something in order to show them that it's not as scary as they think it is, just please be careful. You push 'em too fast, it's gonna make it all worse. And it's gonna reinforce that fear in their brain. And then you're gonna have a bigger thing to deal with later. if you're already seeing a therapist or your child is already seeing a therapist, just ask for their instructions. 'cause they can give you tools or like little stuff to try at home to practice that exposure work. And this goes with phobias or even just general anxieties that can come out of this as well. So.

Christy Wilkie (42:06):

That’s a good point to make because I think sometimes it's easy to just be like, we're just gonna throw 'em into the water and, and make 'em swim because they won't get in. If they won't get in the water, then we're just gonna throw 'em in. And now what you've done is created a traumatic pairing to water and to you honestly. Yeah. 'cause now you are an unsafe person who put them in an unsafe situation that said everything was gonna be okay and it wasn't.

Lucas Mitzel (42:29):

Right 'cause the whole experience was scary.

Christy Wilkie (42:30):

The whole experience was from beginning to end. It was terrifying. And now not only have you probably further traumatized your kid, you've damaged your relationship with your child. Yeah. And nobody's intention is ever to do that. But yeah. Ask somebody, ask a professional.

Lucas Mitzel (42:46):

Right. Yeah. And it's not to say that if somebody listening to this is like, oh no, I've done that. Everything's fixable. I have 100%, yet we, we, this is not something we can't come back from. If you're considering doing something like this, we would just caution you against that unless you have been told how to do it. Because there's a whole protocol on doing it correctly. And that needs to be discussed with somebody who knows what they're doing.

Christy Wilkie (43:10):

Right. And I think it goes back again, anxiety's about control. If the child is asking to do more in that situation, that's a totally different thing than you expecting them to do something more.

Lucas Mitzel (43:20):

Yep. It's crazy 'cause I've, I mean, I've done a lot of exposure work with different phobias and stuff, and it's like all of a sudden, as long as you're, you're letting it go through the process, it's like one day they're really scared and all of a sudden just the next day everything's better. And it feels like magic, but you have to trust the process because if you push them too hard, like Christie was saying, yeah. They can see that they made it through that scenario. But the pairing isn't that everything's fine. The pairing is that I survived.

Christy Wilkie (43:46):

Yeah, <laugh> Exactly.

Lucas Mitzel (43:47): That's really scary.

Christy Wilkie (43:49):

Yep. We don't need to have survival stories. No.

Lucas Mitzel (43:51):

No, no. Absolutely not.

Christy Wilkie (43:53):

So that is, that's a general overview on anxiety and some of the things that we can do to help and things to not do with people are anxious. So, I mean, is it just me or are we all anxious? Well, we're not all anxious, but if you're concerned that you are, I would really suggest that you try to get in with somebody and, and get assessed.

Lucas Mitzel (44:11):

Yeah. We always want to encourage you to ask the question, is it just me? You're likely not alone. And there's always a way to help. If anything we have talked about relates to you, please reach out.

Christy Wilkie (44:20):

Do you have a topic you'd like us to talk about? Message us. We'd love to hear from you.

Lucas Mitzel (44:24):

And don't forget to share us with your friends and family.

Announcer:
Thanks for listening to today's episode of Is It Just Me? To learn more or make an appointment for psychiatric or mental health services at Dakota Family Services, go to Dakota family services.org or call 1-800-201-6495.

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