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.

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Transcript
Is Everyone Feeling Sad

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

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:

Hey everyone, I'm Lucas Mitzel.

Christy Wilkie:

And I'm Christy Wilkie.

New Speaker:

And you're listening to the Is It Just Me podcast

Christy Wilkie:

Where we aim to provide education, decrease the stigma, and expel some myths around mental health.

Lucas Mitzel:

Is it just me, or do people seem really sad lately?

Christy Wilkie:

I don't think it's just you.

Lucas Mitzel:

Yeah. I feel like this would be a really good time to talk about depression.

Christy Wilkie:

I would agree with you. It's a time of year. Yes. Which sounds silly because it's April, but it's true. <Laugh>.

Lucas Mitzel:

Well, depression is a very common term, a common phrase. A lot of people think they know what they're talking about when they talk about depression. Correct. What is it?

Christy Wilkie:

Depression is a chronic lack of energy and sadness that lasts at least two weeks to be a major depressive episode where you can experience either hypersomnia, insomnia, decrease in interest in activities, isolation, not wanting to get up and do things where it's like everything just feels a little harder and it everything feels a little heavier, I guess is the best way. That I can say that. So when people kind of start using those descriptions or they're like, you know, I just didn't wanna go out with my friends. It was like, oh, but you always like being with your friends. And it's like, that's a change in behavior that's notable.

Lucas Mitzel:

Yeah. Some of the not as well-known symptoms can involve lack of concentration or indecisiveness. So like an inability to make a clear choice, or just struggling to make choices. Being tired all day long, or having just feelings of worthlessness or inappropriate guilt.

Christy Wilkie:

Yeah, that's a big one, I think. One that I think, especially in teenagers, but also in adults is irritability. Yeah. Like constantly feeling on edge and that everything everybody does grates on your last nerve and you're like, what is wrong with me? <Laugh>? Yes. That everything feels like it's annoying.

Lucas Mitzel:

Yeah. That one goes undetected a lot. Like if you're assessing yourself, because it's really hard for people, especially when you're depressed, to have the insight to know that you are more irritable. And so it can take outside perspectives to be like, is everything okay? Or you're being really cranky lately, or, wow, sorry, I didn't mean to make you upset. Right. And when you start hearing those things, that can be a sign that, eh, maybe there's something going on there.

Christy Wilkie:

I mean, we'll probably talk about this later too, but responding to things like that in that way can also make somebody feel more depressed because they're like, I know that I'm being cranky and I know that I'm being mean, but I don't want to be that person. What is wrong with me? That I'm like this? Like why am I this way? And then it just kind of feeds into the depression that's already kind of there.

Lucas Mitzel:

Yeah. Oftentimes when I'm trying to assess this with kids, I'll ask them, do you just feel like everybody around you is just extra annoying or just maybe extra dumb? And oftentimes when this is going, they're like, yes, all the time. What is happening to me? <Laugh>,

Christy Wilkie:

Yes, exactly. Adults are the same way. Or you'll get parents that are just like, everything I do, they just yell at me like I can't do anything. Right. And I think that's a feeling that parents have a lot of times when they have kids that are falling somewhere in the depression spectrum is that they're just like, I feel like I can't do anything. Right. I get that too with partners. If you're in a relationship and you know, the partner is sometimes like, I feel like everything I do is wrong or I just can't make them happy. Right. It's like, well, you know what, maybe it's not you. You know, maybe they really aren't happy.

Lucas Mitzel:

And I think that what people don't understand is that this isn't just like you're having a bad day. There's like a physical thing happening inside of your brain where you have an imbalance in chemicals such as like serotonin, where your body's maybe not producing enough serotonin, or you have too many neurotransmitter transporters that are sucking the serotonin out of your brain. So it's not staying in there as long Mm-Hmm. This is where things like SSRIs can be really helpful. SSRI stands for selective serotonin re-uptake inhibitors because it's blocking those re-uptake valves and it's allowing the serotonin to sit in your brain a little bit longer. So that's the whole point behind that.

Christy Wilkie:

You are so nerdy know. That is the science behind depression, which is important for people to know. Because we hear a lot about people just being like, why can't they just snap out of it? Why can't they just be happier? Go out and get some fresh air.

Lucas Mitzel:

Just think positively.

Christy Wilkie:

Yeah, you'll be fine. And that is just it. It just doesn't work. 'cause There is literally a biological problem happening in the brain.

Lucas Mitzel:

Yeah. It's genetic. People who, if your parents are prone to depression or who have experienced that can pass those genes down. Which disclaimer does not mean that if your child is depressed that you did that to them. Just wanna throw that out there. Yes. But there's also some really interesting studies and research just to be more nerdy.

Christy Wilkie:

I'm here for it. Go for it.

Lucas Mitzel:

People who have suffered from depression actually have smaller hippocampus.

Christy Wilkie:

Hippocampus. Yeah.

Lucas Mitzel:

There you go. Plural. And your hippocampus is in charge of long-term memory and emotions. And this often will shrink and make it less efficient. And then evidence has also shown that stress can impair the growth of the hippocampus developing. So if you have gone under a lot of stress or trauma growing up, you're going to be more prone to things like depression, which is not shocking, but there's an actual, we can like see that it's causing a shrinkage or a lack of development in a part of your brain, which is causing you to become more susceptible. Yeah. That's the word. Yeah. To depression. Which is just really interesting.

Christy Wilkie:

It is super interesting. I think we hear that a lot when people are like, what caused the depression? And it's like, well, you can be predisposed to it and you could go your whole life and never have a traumatic event that like makes that kind of come to fruition. But when you're in chronic stress or trauma or there's a traumatic event and all of a sudden it, it just triggers it. That can be what sets it off.

Lucas Mitzel:

Depression is a lot more complex than people understand. And this is why it is so important to have an individualized treatment plan as to how to work through this. Because what works for me may not work for Christy. And what works for Christy isn't gonna work for the next person. Perhaps it could, but it might not.

Christy Wilkie:

Right. Which is why, I mean, you know, as therapists, every person that comes into our office, we don't look at it like, well, you have depression. This is the cut and dried way that we're gonna fix that. We look at, this is your depression. How are we going to tackle your depression? And just because something worked for your buddy, and just because a medication worked for someone doesn't mean it's gonna work for you. You just have to really be open with working and being honest with your provider. To be like, what are we going to do to make this better for you?

Lucas Mitzel:

Yes. And there was another sign of depression that we, we hadn't talked about yet, but it's probably the most important one because it is deadly. And that is having recurrent thoughts of death or thoughts of suicide. Yeah. We're gonna talk about this probably more in depth in a little bit, but if you're having those thoughts, it is not normal. Right. It is not normal to think about dying or to think about killing yourself especially.

Christy Wilkie:

Yeah. Which is interesting because people who are depressed if you've never known anything different. If you've always kind of been in that sort of state, and I mean, I can't tell you how many times people, we always ask the question in every session, have you had any suicidal thoughts or thoughts of hurting yourself or others? And they're like, well, yeah, but everybody has 'em. And it's like, Hmm, nope.

Lucas Mitzel:

That's not, it's like a record stopping

Christy Wilkie:

Squeaky, squeaky. What?

Lucas Mitzel:

Hold Up.

Christy Wilkie:

Exactly. And we're like, ah, no. But when that is so common in your brain, you just assume that that's what's common in everybody else's brain. And so when you tell somebody that's actually not normal to have those thoughts, let's take a look at that. And they go, what?

Christy Wilkie:

It's like, yeah, let's talk about that.

Lucas Mitzel:

Yeah. It's wild. So how is this different from grief?

Christy Wilkie:

Grief is, it's very different. You should feel sad, right? Like I'll ask people when they come into my office have ever had periods of being sad. And they're like, well, my grandma died once. And that was sad. It's like, well, that's grief. That makes sense. That's an event that would elicit an emotion that is pretty appropriate to have given that situation. I forget the timeline that we give grief, which is a whole other podcast because there is not a timeline for grief, but when it hangs on a little too long, sometimes that can turn into a depression. But it's a time period thing in the old DSM. But grief should resolve over time. Depression needs an intervention.

Lucas Mitzel:

Yes. And I think that's the key. When you're grieving, you're gonna see improvement or things are going to alleviate with time. Obviously we're about to get into a can of worms that I don't wanna open up, but <laugh>

Christy Wilkie:

Worms. Worms, Everywhere. Worms.

Lucas Mitzel:

If you're grieving "appropriately," you're going to see some alleviation of symptoms and all those things. But depression, it's either gonna stay or get worse. And there's a lot more self-destructive thoughts involved with depression than there is with grief. Right.

Christy Wilkie:

Grief is an overwhelming sadness about the loss of something. And to be fair, grief is not just death, but grief can be the ending of a marriage. It can be the loss of a friendship, it can be the loss of a dog. It could be leaving high school. Yeah. It could be graduating something. And you know, there, there are happy things that come with endings, but there's a lot of grief that goes into a lot of those things too. And I think you have to kind of redefine what grief means because it's like, grief isn't just death or like a major traumatic event. Grief is a lot of things. And so, and I say that because those depressive-ish sort of feelings can come in when you're grieving anything. And so to be aware that, you know, even if there isn't a major loss in your life, but you're still feeling some of those depressive symptoms, maybe you take a look at what have you lost and what are you losing?

Lucas Mitzel:

Yeah. And I think for a lot of people, grief can be a springboard for depression to trigger. But it, you don't have to have a big event or a loss or anything for depression to come on. And that I think is a huge misunderstanding because I can't tell you how many parents I've talked to or how many kids I've talked to, or adults, whatever, who are like, but nothing happened. Yeah. Like, I'm just sad and I don't know why. And it doesn't have to. Depression doesn't care. No. It's just, it showed up. And here we are and we have to fix it. Yeah. And it's very fixable.

Christy Wilkie:

And we talked about this with anxiety too. You know, the, the number one thing that people ask, well, why are you depressed? Yes. Why are you anxious? When you're in that position? You're really trying to fight to find the reason why there might be that feeling inside of you. And when you can't come up with the thing, you feel like you're even more of a failure. Like, I don't have a reason. Like I have a happy marriage, I have a house, I have good friends, I'm going to school, I've got good grades. Like all of those things can be in place and depression can still be there. It doesn't care what you have or what you don't have, but it really does make people almost feel worse about themselves when they're like, I don't have any reason to feel this way. And as my nerd colleague pointed out, you're you. Yes. You do. The biology of your brain is not working Yeah. The way that it's supposed to work. And that is enough reason why cut and dried.

Lucas Mitzel:

Absolutely. Just like you don't need a prompting event for diabetes to start type one, I should say. Yeah. Besides just genetics. Right? You don't need necessarily a prompting event for depression or anxiety to come on. It's chemicals and brain composition and all that stuff, so.

Christy Wilkie:

Right. I do think too, with depression, when we, when we say what it is, 'cause one of the biggest things that we always see, 'cause it does take some bravery to come into therapy. Right. People living with symptoms for a very long time because they just thought that it wasn't bad enough. I mean, I can get out of bed, I can go to work, you're like functioning in a depressive funk, but that doesn't mean it's not there. Yeah. But a lot of times people will be like, my symptoms aren't bad enough 'cause I can get out of bed, I can shower with everything. It's a spectrum. There's severities of depression. And so it's like, just because you feel like yours is not as severe as it could possibly be, doesn't mean that it doesn't deserve to be treated.

Lucas Mitzel:

Yeah. So what does depression feel like? Because I have talked with numerous clients and they all say the same thing. And that's, if you've never experienced depression, you just don't get it. Right. And I 1000% agree with that. Right.

Christy Wilkie:

When you say, what does it feel like? Of course it depends. I have heard a lot of people describe it as feeling like you're in the hole and someone is just putting dirt on top of you and you cannot dig fast enough to get out. It must feel something like that because more than one person has come to me saying that this is what it feels like. I've heard other people say that. It just feels like there's a dark wet blanket that they have to carry around all of the time and it's heavy.

Lucas Mitzel:

Yeah. Some of the things that I've heard is that it feels like everything you're about to do is like you're about to climb Mount Everest. Right. Or that it feels like you are in this dark tunnel and you can't see where the next step is. Yeah. And it's, it's scary. And you just want to sit down And just hope that the lights turn back on

Christy Wilkie:

Right. It's a really scary place to be. And I think, you know, when you're somebody who's living with someone with depression, it's really hard to see that getting out of bed and brushing your teeth is a huge win. I mean, you gotta meet people where they're at because it is really easy, I think, to get frustrated with people who you love, who you're just like, just brush your teeth <laugh>. Like, can you just not brush your teeth? And honest to God, no. Some people cannot. Yeah, exactly. They cannot get out of, out of bed and brush their teeth. And getting frustrated at the inability to do that does not help.

Lucas Mitzel:

Yeah. And I'll tell you that there's nobody who's more frustrated that they can't do it than the person who can't do it. Right. Because there was a time where they could, and this is really easy for them to do, and normally, and now all of a sudden they dropped a spoon on the floor and they're bawling their eyes out. Right. And they're like, what is happening to me? Right. Or they're in the middle of the shower and they just start crying. Or they got up out of bed and they're just exhausted for seemingly no reason. Right. There are many reasons as to what's going on. Yes. But it feels like there's no reason. Right.

Christy Wilkie:

I think the other thing with depression, I always tell clients the best way to treat it is by doing the things that you really don't think you can do.

Lucas Mitzel:

Yep.

Christy Wilkie:

And that is a really difficult line to walk with people. 'cause It's like, you know what your goal this week is to literally, I need you to brush your teeth three times. Like let's start there. And they don't wanna do that, but it's like, the thing that's gonna make you feel the best is if you can get up, take some steps and get in a shower. And I promise you that you'll feel better. But man, the amount of energy sometimes that it takes to do those tasks when you are in a depressive episode is huge.

Lucas Mitzel:

I like to use an analogy of a parasite when it comes to depression. And for those of you who don't know, a parasite is something that has to,

Christy Wilkie:

There's my nerd friend again. Here we go.

Lucas Mitzel:

Shut up. A parasite is something that needs to feed off of a host in order to live. So it steals from the host in order to thrive, to replicate whatever. And so depression feeds off of your happiness, it feeds off of your energy. And in order to feed that, you would need to do the things that it's telling you to do or not do. Such as oftentimes depression will tell people, stay in bed. It will tell people, don't go out and hang out with your friends. It'll tell you to quit all of your sports or stop trying in school or whatever. And all of that seems way easier to do. And then when you do it, you feel horrible that you did it because depression is mean. And the way that you combat that, one of the best ways that you can combat that is by doing what Christy was just talking about.

Lucas Mitzel:

The term for that is called opposite action. And it's not complicated at all. It's literally just doing the opposite of whatever your depression is telling you to do. And when you do that, it's hard at first because that's your parasite throwing a tantrum that you're doing the thing that it doesn't want you to do. And then afterwards you're gonna start to feel better. Now I just want a disclaimer. It's not like you go take a shower and then all of a sudden your whole day's better and everything's fixed. Right. That's not how it works. Like this is a long process. You have to starve the parasite. Like it's still gonna be there. And after a while of doing this and working through some of these things, you're gonna start feeling better because that parasite's gonna get smaller and smaller and have less power over you.

Christy Wilkie:

And you know, people do have good and bad days. There are some days where it doesn't feel as heavy and then there are days when it feels like it's super, super heavy. And I think sometimes those not as bad days really give people some almost false hope. They're like, okay, I'm better. I don't need the help because I had a good day. So it's fine. It's like, no, that can sometimes be a liar.

Lucas Mitzel:

Yeah. And another way to think of that is maybe even not as a liar sometimes, but just, okay, let's capitalize on this. Because those good days are the days that we can put in more skills and put in more opposite action. And you can kind of like in a sense, bank some of those opposite action. Like in starving that parasite. So then if tomorrow maybe is a little bit harder, you've had all of these really good experiences, maybe some good memories that day. And you can fall back on that and be like, yesterday was a really good day. And so I know that it can get better. Yeah.

Christy Wilkie:

When you know what it feels like to have the load lightened a little bit, that is almost a little bit of motivation to be like, I wanna capture that. Yeah. How can we do that again, how can I have that kind of day again? I also have a lot of this is more so in kids because the kids really have this people pleasing part of them for the most part, where they don't talk about their depressive symptoms because they don't wanna make somebody else feel guilty that they are depressed. Like they'll come in, my parents do all of the right things for me, but I still have all these feelings and I don't wanna tell them that because they'll think that it's their fault. I mean, which is honestly, all of those are depression symptoms. Absolutely. I mean those are all cognitive distortions that we talk about when we do CBT with people that have depression. And it's not just kids that happens in relationships too, where they feel like if, if they're honest about how they're feeling about their depression, that their partner will feel like it's their fault that I'm feeling this way when I don't feel like it's my partner's fault. But that's how they're gonna feel. And it's like, you just gotta talk yo. Mm-Hmm.

Lucas Mitzel:

It goes back to, I mean, one of the hallmark things that depression tells you is that you're a burden and that you just need to suck it up by yourself and don't talk about it. Because if you talk about it, you're gonna be a burden to somebody. And that's not good. 'cause We care about people when that is the exact opposite of what is true. Depression's really smart and it really is good at tricking you into doing the thing that is harmful to yourself in an effort to do the good thing. Right.

Christy Wilkie:

And I, not to stereotype our state, but kind of North Dakotans in general are not overly emotive people. There's not a lot of like, yes. Let's talk about our feeling sort of messages, that are being sent by a lot of people. You know, just culturally speaking in the Midwest, you know, it's like you pull yourself up by the bootstraps, you get through the day, you get done what has to get done. And that mentality of this we do see with parents, it's like, well, I felt that way and I was able to get through it. So they should be able to just, you know, pull their bootstraps up and get through it too. And it's like, no, when we know better, we do better. Just because you lived miserably for a long time doesn't mean that we need to hand that down. Yes. You know, like we can fix that for the next generation. Right. But we have to start talking about how we're feeling, which is so difficult for everybody but men. A lot of the time there's more stigma around men talking about their emotions than there are women.

Lucas Mitzel:

Yeah. I mean, just talking about North Dakota, 80% of the people who attempted suicide were men. Yeah. And that says something, right? Like, we need to talk more about what's going on. And it doesn't have to be this incredibly lengthy or detailed like expression of your feelings, like a letter or a song or something like that. Nobody's asking for that. Just, I

Christy Wilkie:

Might actually fair, if you would like to write a song about it, I am all ears,

Lucas Mitzel:

But you know, I'm having a rough day today. Like, that's all it's gotta be. Right. Or hey, can we hang out? Like it's just been hard, you know, like people wanna be there for you. Yeah. And if you can't get off of the idea that you're a burden, then you're a burden people want.

Christy Wilkie:

You're trying to push people away and they're still asking how you are. Oh my God, how annoying. Right. People actually care about you. But we talked about this too with anxiety where if you can name the emotion that you're feeling, if you can identify it and you can say it either internally, externally write it down and just be like, I am feeling sad. That decreases the intensity of that emotion because you're naming it and you're becoming in control of it rather than it controlling you. And it sounds so easy, but it's not. I mean, Lucas, you're a therapist. How many times a day are you like, you know what? I am feeling angry today.

Lucas Mitzel:

Very little.

Christy Wilkie:

Yeah. But we should do it more. We teach people to do that because if you're anxious or you are depressed or you're sad and you can know what it is, there's some control that comes with knowing what it is that you're feeling. I mean like, okay, now what are we gonna do with it?

Lucas Mitzel:

Yeah. And I think that just to capitalize on something you said a little while ago,

Lucas Mitzel:

But be kind to yourself when you do something like take a shower, brush your teeth, whatever. I have people who come into my office and they're like, nothing went well today. I didn't do anything today. And I'm like, you're literally sitting in my office like you are depressed. And you got up, you got dressed, you took a shower today, you brushed your teeth, you got in your car, you drove across town, you're sitting in my office and now you're talking about really hard stuff. Holy cow. That is awesome. Yeah. Right. Because you can't tell me that, like I said earlier, that getting out of bed didn't feel like the hardest thing in the world and you fought tooth and nail to get outta bed. Right. Like you deserve a round of applause. Yeah. That is amazing.

Christy Wilkie:

Even if they open up a telehealth appointment. Yeah. If you got outta bed and you didn't feel like leaving your house, but you were still able to connect via telehealth for your therapy appointment. Oh my God. That's huge. But people in general, I think this isn't just people who are depressed, but people are very prone to deficit thinking where you're thinking about all the things you don't have and all the things that are going wrong and all the things that are bad. Instead of training your brain to notice all of the things that you're doing right. And all the things that are good. And when you're depressed, it is really hard to find those yourself. They need to come in and be like, Lucas, this is a terrible day. Look at this. And for you to be like, oh no, Uhuh. Like, look at all these things you did. Because they literally can't see that in their heads as positive things or things that were going. Right. Because their, their brain doesn't let 'em see it like that. But when somebody else can point it out, they're like, oh yeah. Okay. So then you learn to train your brain to start looking for some of those things that are good and positive, rather than always focusing on what's not good and things you don't have. Look at what everybody else has that I don't have. Yeah.

Lucas Mitzel:

If you think about it, like if you got into a really bad car accident or something and you couldn't walk or something happened and you just couldn't walk, you had a spinal injury or something before that, walking was really easy and taking a step was nothing. And now it is huge. And when you finally take that first step again and retrain your brain how to walk, I mean, you can find videos of this all over the internet. It's a huge celebration. Yeah. But it was such a air quotes, simple thing. It's the same thing with depression, right? When you're doing those things that used to be easy, but they're not anymore because our brain is not working right the way that it should. And so everything feels harder. And so when you do those things, we need to celebrate that. Right. And when you can celebrate those little things, you're gonna start to feel a little bit better.

Christy Wilkie:

And if you're somebody who loves somebody that has depression, how important it's to help them see that too. To be like, Nope. Applaud them for, for that. And sometimes they'll be like, this is stupid that we're celebrating me getting outta bed. Well no, actually it's not stupid. Right. And I'm gonna celebrate you when you start to hang out with your friends again too. Or when you start golfing again, or when you wanna go for a walk outside. Those are all milestones that deserve to be celebrated and pat yourself on the back for that. Which we're really terrible at doing too.

Lucas Mitzel:

Absolutely. Especially in this area.

Lucas Mitzel:

Some other things that people can do that are really simple in practice, difficult to actually do it. You can do something called accumulating positive experiences, which is essentially doing things you enjoy, or in this case, probably used to enjoy. I always ask people like when they weren't depressed, what are some things that you used to do that you found fun? And then let's force ourselves to do them again. Because the more we do them, we're going to starve that parasite to keep going. Back to that analogy. Another thing you can do and you can combine these two is called building mastery. And that's where you do something that is difficult enough that it feels good, but it's not easy enough where it was nothing. So for example, how far did you exercise today? Or how long did you exercise today?

Christy Wilkie:

I ran for 10 miles today.

Lucas Mitzel:

You're insane. That's true. Right. So that probably felt really good. It did. Okay. If you had ran half a mile today, would that have felt as good?

Christy Wilkie:

No.

Lucas Mitzel:

Right. It probably, and if somebody, and if I were like, I'm just being honest. Yeah. No, and that's totally fine. That's what I wanted. So, but if I, if you had ran half a mile and I was like, wow, good job. Would you think that that was weird? Yeah. Yeah. Because it's not hard enough Right Now if you were depressed and you had no energy and you ran half a mile, that would be amazing for sure. Yeah. Yeah. So this is all relative to where you're at and how you're doing. So you have to find what that is for you. Yeah. And when you start building mastery at things and getting better at it, you're gonna have dopamine dumps in your brain and you're gonna just start simulating some of those successful moments and it's just gonna start feeling better overall. And then if you're combining that with things that you enjoy, it's even more so.

Christy Wilkie:

Yeah. I think we also have to be careful too sometimes so it doesn't feel condescending when you're cheering people on for doing something like that where it's like, good for you, you ran a half a mile. Like way to go. You know? It can, it can feel kind of condescending. Yeah. And I think it's more or less meeting that person where they're at and helping them see it differently. Like I could see someone with depression with somebody being like, let's go. You got it. Let's just be happy. You know? Because that doesn't work It doesn't work to just say, let's be happy. Sometimes it's just like, you're grumpy and I'm gonna sit here with you being grumpy and that's fine. You get to be sad, you get to be upset. I'm not gonna force you to be any sort of way. I just don't wanna send the message that we're like, just tell people to take a step out of bed. 'cause It's not that. Right. It's like, you know what, I get that you're in a bad place and I'm gonna sit here with you and we're gonna figure this out. Yeah. And just offering an open space for people to talk.

Lucas Mitzel:

Absolutely. And in that moment that just sitting up in bed and talking, that might be the most successful thing that happens. And that is awesome because

Christy Wilkie:

Nobody's trying to change them. Yeah. Because I feel like that's where a lot of pressure comes in with people that have depression is that everybody wants you to be happy. And they know that, like they know that people want them to be happy and so when they aren't, they feel like they're letting so many people down. But you also don't want them to fake it. 'cause That is a whole other podcast too. But that is dangerous to have to mask because you are worried about other people are going to think about your depression. And so allowing the sadness emotion to be okay and validate that it's okay to feel that way is so powerful. You just don't even understand how powerful that can be, I don't think. Yeah.

Lucas Mitzel:

I would argue that one of the most powerful ways to combat depression is to talk about it. And that doesn't mean that you're trying to fix it or solve the problem. It's just venting about how this feels and what's going on. And having somebody just sit there and listen and just hug you or just hang out with you in the midst of that is some of the most powerful healing that you can do for somebody. And some of the most powerful healing that you can do for yourself. Because the one thing depression wants you to do is to stay silent and to act like everything is okay because then it's just gonna keep on growing.

Christy Wilkie:

Or what can I do to make your day better? What can I do to make things easier for you today? Just simple things like that where you're not trying to change how they're feeling, but you're trying to support them in their recovery to feel better.

Lucas Mitzel:

I think that for parents it's important to know that depression can kind of look different than like classical air quotes, classical depression would. And so what are some things that we can maybe talk about for parents? What are some of the tips you give parents to like kind of help them screen for depression? Or maybe just things that they can do for their kids in general.

Christy Wilkie:

One thing that's super simple to implement is just like a daily check-in, and I'm not talking at the dinner table, which is fine, we can talk at a dinner table. There's nothing wrong with talking at a dinner table <laugh>, but sometimes there are emotions that people don't wanna share with the whole family. So like taking a time with like five minutes into a check-in at night with each kid on their own. One-On-One. So they can be like, Hey, let's talk about your day. How are you doing? How is it going? If you have a child that's going through a difficult time, particularly, I would do that check-in probably more than once a day. Just say, Hey, what's up? How are you doing? One of the easiest phrases that we can ever say, if you notice any change in behavior, right? Because a lot of times, especially in the teenage years, there's a number of changes in behavior that we just chalk up to.

Christy Wilkie:

That's just teenage behavior or that's just being 16. That's just whatever it is. And it's like you don't know that any change in behavior to me as a therapist is significant. Any change. And unless I talk to somebody and have a feeling of where they're at, I'm not just gonna chalk it up to hormonal behavior. I'm not <laugh>. I'm gonna be like, okay, what's up with that? And so that's, that's the phrase that we use all the time is like, Hey, I've noticed that you're spending a lot of of time in your room lately and I'm not mad about it, but what's up with that? Like, is everything okay? Is, is there anything that we need to talk about just offering a safe space that isn't judgmental, which I think is the hugest thing. Or like coming at it in a place where you're in trouble 'cause you're secluding yourself from the family.

Christy Wilkie:

We hear that all the time, right? Yeah. They're in their room all of the time. They don't wanna be with the family. Like, you have to come up and spend time with us instead of going that direction and making people have to do something because that's what you think they should be doing. Let's look at why they're not doing what they're doing. Let's search for understanding rather than judgment. And I think that that's some of the most powerful stuff that parents can do is to create a safe space for communication and also not judge the behavior that's changing, but seek to understand it. Yep.

Lucas Mitzel:

I think some other significant behaviors that we need to just be on the lookout for would be any sort of discontinuing of hobbies. Or if they are wanting to stop sports, if they're like really athletic and then they stop those things, that can be a pretty big indicator that there might be something going on. And I say it's always might or we just gotta check because it could be nothing. Right? It could be hormonal teenage behavior.

Christy Wilkie:

It could be that their sports team is toxic because that is also another podcast. But it could be that that's a healthy decision that they're making too.

Lucas Mitzel:

Grades slipping. If there's any sort of changes in their sleep schedule. So if they're having a hard time going to sleep or they're not able to wake up, big sign for kids and yeah, it's pretty normal for teenagers or kids to want to sleep in, but if they like cannot get up that makes me question things a little bit.

Christy Wilkie:

Right. And maybe it's not depression, but it could be something else. And that's why it's just like those noticeable changes in behavior. Eating more than normal, not eating enough, bringing food into their room, which sounds really stupid, but when you're depressed and if you can get food that snuck into your rooms, you don't have to get out of bed again to go and get more food. That is something that we see pretty typically with some kids.

Lucas Mitzel:

Yeah. With our perfectionistic kids who are <laugh>. Yeah. I know nothing about that. <Laugh>. The one thing that can be really dangerous, this kind of goes back to our anxiety podcast a little bit, is that when you're perfectionist and you're not meeting the standard, you can have very self-defeating talk towards yourself. And it's really important that we don't just ignore that. And we really try, I always encourage parents to try and challenge that. And by challenge I don't mean confront them about that in like a harsh way, but like talk about it in a concerned way. 'cause I don't ever want to hear any kid talking poorly about themselves. Right. 'cause Every kid that I know is amazing. Yeah. And I want them to think that about themselves too. And so it's really important that we talk to 'em about that because the, the stuff that they're saying out loud, I get really worried about what's going on in their head. Because we typically say way more to ourselves in our head than we would out loud. And if so, if it's getting so bad that it's coming out loud in front of people, ugh. I get really worried.

Christy Wilkie:

Right. I've said this a million times, but the scariest depression is the one you don't see. Because that can be really tricky, especially when you have perfectionistic, overachieving people pleasing children. And we know that anxiety and depression are buddies. Like they link arms and like skip to the loo through your head. And so anxiety and depression are very commonly co-occurring. And so that anxiety can lead to depression and vice versa. But you get those people pleasing kids that don't wanna be a burden, that don't want anybody to worry about them, that wanna make sure that everything is perfect. And so they're masking, which is essentially looking one way on the outside that's not congruent with how they're feeling on the inside. And pretending like everything is always okay. And I mean, those really are the tough ones. And that's when you've got some of those perfectionistic, high achieving kids.

Christy Wilkie:

I feel like those danger signs are a little different. It's almost like an obsession with homework, an obsession with getting things done. And just because they've always been that way doesn't mean that it's healthy. So it might not be a change in behavior, but it's still an unhealthy behavior. And so to kind of look at some of those things and just always check in with your kids and be like, do you wanna be doing these classes? Like are you enjoying taking four AP classes? Yep. Is this fun for you? Like, and making sure that there's no pressure for them to take that on your behalf because you will agree with me on this one. We have kids that come in all the time and they're like, if I don't get an A, my parents are gonna be so mad. And I'm like, have your parents ever gotten mad at you about your grades? And they're like, no, <laugh>. And the parents will be in there and the parents will be like, I don't care if you get c's. Like, I just want you to be happy. So there's this unrealistic expectation that's never been stated to them that they believe is true or they suck.

Christy Wilkie:

It's a cognitive distortion. But you have parents, you have teachers that, 'cause then people will be like, well I'm gonna let my teachers down. Your teachers want you to learn and be happy. Your teachers don't care if your GPA is 4.0 plus your teachers want you to go on to school and figure out what you can do to be happy in your life. But it is pervasive that kids feel that way. Depressed kids. Yeah. Like if I am not perfect, then I am letting someone down. And when you ask them to pinpoint who it is that they're letting down, they don't know <laugh>. Right. They have no idea. They assume it's their parents. Their parents. Like it's not me.

Lucas Mitzel:

Undiagnosed or untreated anxiety oftentimes can lead into depression. Sometimes one of 'em moves out for a bit and then the other one moves in. Sometimes people who get real lucky, they just become roommates and they just party. Yeah. That's tough.

Christy Wilkie:

Hard. They leave a mess everywhere they go. They're

Lucas Mitzel:

So rude. They

Christy Wilkie:

Are not good tenants. <Laugh>, if they apply for your Airbnb, tell them no.

Lucas Mitzel:

Right. And obviously, or at least I hope this is obvious, but if there's any talk of suicide, if you hear any sort of talk about death or suicide, like they need to get assessed. Mm-Hmm. It has been going on probably too long. And it needs to be looked at. We need to work on that because now it's becoming life and death. It's very serious. And I can't stress that enough.

Christy Wilkie:

Right. I do think it's difficult for parents at this day and age because the KYS, which is very common in texting, which is kill yourself. Is very, very common. People telling kids to do it. And then people also saying, well, I'm just gonna kill myself. Which sounds really flippant a lot of the time. And I know a lot of people struggle with what do I take seriously and what do I not take seriously? Everything.

Lucas Mitzel:

Everything.

Christy Wilkie:

We take everything seriously. If your kid is using those words or they're using it towards themself or somebody else, you sit down and you have a very frank conversation about, Hey, are you having these thoughts? Because I will get you in to see somebody. And to also explain the gravity of what those words mean and what they could mean to other people. Because you can get non-depressed people, people who have never had a suicidal ideation. It comes off as a joke to them sometimes. 'cause They don't realize what that could mean to somebody who's actually had those thoughts in their head. Do they really want them to go kill themselves? Probably not. But it's something mean. It's something cutting. It's something that they don't think that that person is ever gonna do. But if you say that to somebody who's had those thoughts that have said, I don't belong here, I shouldn't be on this earth. And then that's the nudge that they have. That can be the thing that that triggers 'em to be like, see, that person thinks so too.So we take everything seriously.

Lucas Mitzel:

Everything. And when you have a conversation with your child about their own suicidal thoughts, it's important to have a frank conversation. To be very blunt, we don't beat around the bush. We just ask, are you thinking about killing yourself? Contrary to popular belief, you're not going to actually increase the risk of suicide by doing that. You actually decrease it. Because now we're talking about it. But it's also important that although we say a frank and a blunt conversation, this is filled with love and care and compassion. And you are gentle because they're in a very fragile state if they are thinking of those things.

Christy Wilkie:

Yeah. If you are a parent and you're struggling with a child and you don't know how to talk to 'em about these things, call us. Yeah. We will help you. We'll walk you through it. We will help give you tips and pointers on how you can have that conversation with your child. As a parent, we always believe that you are the expert on your child. You know best. You know them, you love them, you want what's best for them. We will just help you figure out a way to work with who your child is personality wise and what they're dealing with and what their history is to help you have that conversation in the most effective way that you can.

Lucas Mitzel:

Absolutely. It's really important that when you are working with your kid, if you have any of these things going on, that it's always beneficial to have somebody else who's helping you learn the best way to work with your kid. Because we're giving you a bunch of general tips. But to know exactly what is going to be helpful, I would need to meet with your kid. Yes, totally. And talk with them and then give you some tips on how to work through stuff. They're gonna say some things and two kids can say the exact same phrase and it can mean very different things. Yeah. So it's really hard for us to give the, just the general outline of this is what you do in every single situation. Right. Because that's not how it works. No. So if you have a child that this resonates with or you're really relating to these things, I would really recommend that you seek out help if you don't already have that. And if you are seeking help, don't be afraid to ask us. That's what we're here for.

Christy Wilkie:

Yeah. I think that's what we're here for. <Laugh>. That's like literally my job as a general rule when kids do talk about their emotions. Because I think it's really easy to go towards, I wanna get control of the situation as a parent. When a kid comes to, well, anybody. And not I, I just talk about kids because we see a lot of kids, but this can be anybody, but somebody comes with you and they say these words, you know, I'm thinking about killing myself or I, I'm really not happy. Anything in that vein I think causes a lot of people to parents to find a way to get control of that situation. And so sometimes that control comes across as consequences. And that is not beneficial. 'cause They're like, well now I'm taking away your phone. You don't get your keys, you don't get whatever.

Christy Wilkie:

Like you, you go from taking away everything that's going to help them maybe deal with their emotions because you're scared. And I understand the scared. Absolutely. I absolutely understand the scared. But, and this comes down to where, you know, you work with a therapist or something to help figure out how you can communicate with one another about where you're at with your emotions. I promise you that if your child is telling you that they are having suicidal thoughts, they do not wanna die. They're talking to you because they want to live. Which is step number one. I've talked with Lucas about this a number of times too, where if you have a dysregulated crying baby right? What do we do? We give them food, we change their diaper, we hug them, we bounce them, we swaddle them, we nurture them. We love them.

Christy Wilkie:

We hug them, we give them all the toys that they want. We like, what can we do to make it feel better? And it's like as you get older and you start to get distressed in any sort of way, or you're showing signs that things maybe aren't great, the knee-jerk reaction is to start taking away the things that make you feel comfortable. We're gonna take away your phone. You can't go anywhere, you can't be with your friends. We're gonna ground you. Instead of saying, what do you need for your body and brain to feel better? Like how can we do that? At some point we just forget doing that. And it really is in those teenage years because then again, as an adult, people are like, dude, take some self care. Take a day off of work. Binge watch a show, scroll TikTok for a while, spa day hey.

Christy Wilkie:

You know, it's like as an adult you get that sort of leeway to be able to take care of yourself. But in these teenage years where we're trying to form these brains that are not quite put together, we start taking away the things that make them feel loved, cared for, nurtured, connected, socially connected to things, which is super important. So I always wanna stress that before you start giving like these huge consequences to kids, especially if they're talking about their emotions or whatever it may be, let's look at what's causing the behavior rather than just consequencing the behavior, I guess.

Lucas Mitzel:

Right. Just to clarify too, we're not saying don't give your children consequences for their behaviors. Correct. This is different quite specifically when we are talking about sharing feelings and things like that. Like there should never be a consequence when we're talking about our feelings. Kids who are depressed, anxious, or dysregulated are not going to do it necessarily Well. And so we can adjust how we talk about those things. But I think that for the most part, when it comes to emotions, never should there be a consequence about that. But we just need to be cautious as to why we're doing something or is this really what would be the most helpful. And also just to bring it back to like depression and suicide, like if you have a child that you know is struggling with this, be cautious about consequences. And I'm not saying don't give them to them again, I'm not saying that, but just be cautious because any sort of extra negative or extra sort of thing put on them, it can be dangerous and can lead to some more intrusive thoughts and just negative thoughts that we really don't want.

Lucas Mitzel:

And so if you have to do something, then maybe do some extra check-ins and just seeing how they're doing and how they're processing through that. Because we can have a consequence and process through that in a way that does not lead to more danger or more harm. Right.

Christy Wilkie:

And I mean, we have to talk about social media all the time. My whole life is consumed with looking at kids' social media. I feel like half the time. But we can't have a conversation with them though.

Lucas Mitzel:

You're not just like looking at children's social media. I just wanna clarify.

Christy Wilkie:

They show It to. No, I'm like, gimme your phone <laugh>. No, but there's a lot of stuff that happens on social media that people are not aware of. And for sure parents aren't aware of. Teachers aren't aware of. I mean, I see a lot of things that kids share with me through social media. And so I always caution parents because it is important for these kids to be connected. It's so important for them. But it doesn't mean that we let 'em have it willy-nilly. Like there is a safe way for them to have social media. Do. Do they know the people that are on there? Do you know who they're talking to? Are they having open conversations with you about who they're talking to? There's a way for you to allow your child to have social media even if they're struggling. That is safe.

Lucas Mitzel:

Yeah. And if you're not sure how to do that, like maybe you're not as technologically literate as maybe other people. There are plenty of sites out there that can help you explore what options you have if your child is talking to a therapist. Like we all have to be very up to date with social media if we see kids.

Christy Wilkie:

I am the hipster 44-year-old. I know <laugh>.

Lucas Mitzel:

I have kids who quiz me on the different slang terms and I always get it right.

Christy Wilkie:

I know. I was like, do you know what I talk about in here all day? Yeah. Yeah. Like, do you know what Snapchat is? Oh yes. Offensive.

Lucas Mitzel:

I know. I was there when it was made.

Christy Wilkie:

I knew life before Snapchat.

Lucas Mitzel:

Right. And then they're like, you're old.

Christy Wilkie:

And they're not wrong. No.

Lucas Mitzel:

So when it comes to suicide, just to get a little bit more specific here too, I think it's important to talk through two main categories of suicidal thoughts. And it's passive suicidal thoughts and active. Both are not okay

Christy Wilkie:

Nor normal.

Lucas Mitzel:

Nor normal. But passive suicidal thoughts are what a lot of times people think are just the normal ones that everybody feels. And that's where you're just kind of like going about your day and all of a sudden you just have this random thought pop into your head of like, oh, you should die, or you should drive off this bridge or something.

Christy Wilkie:

Well if I got hit by a car, that'd be fine.

Lucas Mitzel:

Yeah. Things like that. And it just popped in your head. It's intrusive. It's like the Kool-Aid man busting through the wall.

Lucas Mitzel:

There's gonna be a day where people don't know that reference. But it might

Christy Wilkie:

Be today,

Lucas Mitzel:

Actually. I don't wanna talk about that. But we're okay. And then there's active thoughts and that's where we're, we're playing with them. We are consciously thinking about this and we are making plans and we have an action plan surrounding that. And those are by far the more dangerous ones. But they're both not normal. So if I have a kid who's just saying like, you know, I had some passive suicidal thoughts today. Like we're gonna talk about those things and try and figure out what's going on there and try and work through that. If I have somebody who's actively suicidal is the term, that's where we're more panicky. In regards to, we're not panicking, don't panic, but that was the wrong word. But rewind, like the lights are going off, like fire alarms are going off in my head, like, we need to really take this seriously. In extreme cases, this might be where we need to look at hospitalization in order to keep somebody safe. Yeah.

Christy Wilkie:

Or for sure come up with a safety plan. I mean, and again, it doesn't matter because if there's any sort of indication that there are active suicidal thoughts, you have to get your person, whoever it is, child, friend, brother, sister, niece, whatever. You have to get them in to see somebody. And I would keep your eyes on them 24/7 until you can get them in to see somebody. Absolutely. So that's a no go in my world. If, if you've got someone who you know, who is actively suicidal, who has a plan, who has the means, who is saying, this is where I'm at, you keep your eyes on 'em until you can get 'em into a provider.

Lucas Mitzel:

And if they're saying something and you're just not sure, and like let's say you can't get ahold of your regular provider or you don't have a regular provider, or you don't, or you don't have one take them in to get assessed. You are not trained in how to do this. Do not do this yourself. Just have somebody else take a look at your kid and make sure that things are okay. Or it doesn't even have to be kid. If it's a relative or a friend that's an adult, like just get them in to go see somebody. They're not going to admit them to a hospital if they don't meet requirements. They barely have enough beds as it is. So they're not gonna put you in if you're not suicidal. So, or if you're, they don't feel like you're a risk to hurting yourself. Mm-Hmm.

Christy Wilkie:

I do think that one of the barriers to that is that a lot of people don't wanna go into the hospital. And so people will get upset and they're like, I don't wanna make them more mad by making them go and get assessed. Yeah. And that is a very tricky situation to be in. And I think for me it's like I'm keeping my eyes on you then 24 7 until you can decide how you wanna go about it. I mean, every person is different, but you gotta get 'em in to see somebody. Somehow or other.

Lucas Mitzel:

And if you're seeing a therapist or your child's seeing a therapist, talk with them about what that safety plan needs to be. Because they're going to know what's best for those situations. They can give you very specific individualized plans as to how to handle those situations and make sure that everybody's making the safe decisions right. In those moments. And then you're not just making it up as you go. You have somebody who actually knows what they're talking about, giving you plans and instructions. Yeah.

Christy Wilkie:

I think coming a little full circle from when we said, is it just me or is everybody kind of sad lately? And I kind of flippantly made, well it's April, which sounds kind of weird, but we would be remiss to not tell people that April and May are the highest times for suicide. Most of the time, if you ask people in North Dakota, they're like, well, it must be in December and January and it's because it's cold and it's gross and it's dark. And it's like, yeah, it's not true. It's actually in the springtime. And that's for a number of reasons. One, it's really easy to explain away your depression in the winter because people are like, well of course you're sad <laugh>. Like it's dark and it's cold. And you don't get to see people as much as as you want to. So you can justify almost why you're feeling sad.

Christy Wilkie:

And you know, one of the biggest things that we hear people say is, you just gotta get some sunlight. You just gotta get out and get some sunlight. Right. So when spring rolls around and there is some sunlight, and most of us know what this feels like when I say this, but when spring rolls around and you kind of feel that lightness in your chest, it just kind of feels different around spring and you know what that feels like. And people are out walking around and golfing and outside running and doing all these things and you're still in your depressive funk and you are not feeling any better. And in fact you may be feeling worse. That's kind of where you hit this level of hopelessness, where it's like, I'm gonna feel like this forever because the sunlight isn't helping. If this is gonna last forever, I don't wanna do it. And the other part is that the sunlight will allow people just the small amount of extra energy they need to actually act on the plans that they had made during the winter time. So that's the other part is that it does give you a little extra boost of energy to maybe act on the, on the suicidal thoughts that you've been having. Right.

Lucas Mitzel:

It's really important when we talk about suicide, 'cause you mentioned that there's like the silent depression is the scariest, and there are warning signs that we can look for that are silent, that are the most dangerous. And some of those can be selling your possessions, or if your child or your friend is getting rid of stuff, especially things that are important to them and saying goodbye to people or just like thanking you for things like out of the blue or apologizing for things out of the blue. There's no real context as to why that's happening, or the most dangerous is suddenly doing really well. So if you have somebody who's been just constantly depressed, then all of a sudden they're just like in the best mood ever, we need to go to a hospital. Right. Because at that point, they've likely made a plan. They know it's going to happen, and they've experienced this sudden euphoria about them because all of that stress and anxiety, it's all gonna end. Yeah. And so there's no reason to be sad anymore because it's gonna end. There's a light at the end of the tunnel, they've just created the light. So when you're seeing that happen, it's very easy. And it's common where we are just like, oh my gosh, they're better today. Yeah. And we're just gonna have a really good day. And then the worst thing imaginable happens. Right. And so really be aware of that if you're seeing that.

Christy Wilkie:

We take suicide very seriously and everybody should period.

Lucas Mitzel:

Absolutely.

We always want to encourage you to ask the question, “Is it just me?” You are likely not alone and there is always a way to help. If anything we have talked about today resonates with you, please reach out.

Christy Wilkie:

Do you have a topic you’d like us to talk about? Message us. Our email address is isitjustme@dakotaranch.org. We would love to hear from you.

Lucas Mitzel:

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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