Dr. Megan Spencer is a clinical psychologist at Dakota Family Services. She is passionate about working with individuals and their families and highly values the therapeutic relationship. Dr. Spencer enjoys helping people better understand themselves and their psychological functioning. She looks forward to working with anyone who is looking to better understand and/or improve themselves or their children and families. Her practice includes diagnostic and psychological evaluations and individual cognitive behavioral therapy.
April Morris, LCSW, provides therapy for adolescents and adults. She enjoys working with clients from all walks of life, and is honored to join them on their mental health journey and help them build skills to adapt to life challenges. She loves building relationships with people and is dedicated to helping them become their best selves.
Featuring Dr. Megan Spencer, Psychologist, and April Morris, LCSW, Dakota Family Services
Tammy Noteboom:
Community chat recordings are presented by Dakota Family Services, an outpatient clinic with mental health providers in Minot and Fargo, North Dakota. Thank you for listening.
Randi Streff:
Alright. Well, thanks everyone for being here today with Dakota Family Services. We have Dr. Megan Spencer and April Morris, who both work out of our Fargo office, and they're gonna talk a little bit about depression in children and adolescents, knowing that sometimes it can be difficult for caregivers, parents, friends, things like that, to identify what depression looks like in children and adolescents. So they'll talk a little bit about some awareness things. It's ideas for interventions and just overall how to notice when children and adolescents are experiencing depression. So from there, I'll turn it over to Megan and April.
Megan Spencer:
So kind of our, our topic today is, is more focused specifically on depression in the kiddos and adolescents. So not focus on adults but very specific to the kiddos and teens. So I think it probably seems relevant that we just kind of start maybe more broad and talk about some things that, as parents and caregivers, you guys may notice. Right? So not necessarily in the clinical sense, but just kind of typical things that you guys as, as parents, caregivers or individuals may notice yourselves in terms of some of those kind of signs or symptoms that warrant a little more attention or could indicate depression in your child or teen. I always like to kind of start with the caveat that we all kind of have an idea of what depression can look like, right? We kind of get the typical TV media Eeyorewhich absolutely can be indicative of depression.
Megan Spencer:
But I think the other thing we like to talk about too is specifically with kiddos, it may not necessarily be that really depressed, sad mood, and it might really honestly be more of an irritable mood versuswhat we think of as sad or depressed mood. And so kiddos that, that could still indicate depression if it's not necessarily depressed, but far more irritable most of the day or, or nearly every day. The other thing too, I like to mention in kiddos is even with adolescents, sometimes they don't necessarily have the words to say, I'm feeling depressed. Right? But they may say, I feel sad, or I feel empty, or I feel mad all the time. Right? And it's not that they're angry, it could be that irritable piece. They just don't know how to put that into words. Or even with kiddos or teens. It could be more observable versus what's subjectively stated. So it could be more that they're just a lot more tearful. Right. Would definitely indicate some of those mood changes. Right. So tearfulness, bouts of crying, increased crying, that seems different than what has been previously the typical presentation,
April Morris:
I think too, like being less talkative. Maybe they normally like to talk about what they did today or tell you about their favorite game they're playing and now they're just not, or you ask questions, they're like, nah, I dunno. And so sometimes just when I was thinking about when you referenced Eeyore, I do like to use him as a reference because with him you can tell that there is some "okay," like tone and voice, but it can be confusing cuz he still participates.
April Morris:
He still goes with everybody. And, and with, sometimes with depression, you may pull back from activities that you like. So each of these symptoms or signs we're talking about, they don't have to all be present and to keep in mind that we're watching for at least a handful of them over a period of time. But like that low energy, tired change of motivation, participating in their usual fun activities or just pulling back less, or pulling back more, sorry, from friends or even family.
Megan Spencer:
And I think it could be, you know, that it's, right, it's kind of observing the behavior and the mood. So yes, we talked about kind of that mood being more sad, depressed, maybe the mood is more irritable. And, and that irritability, if you think about it, right, we all kind of have a fuse or a tank, right? And so if your kid or adolescent is struggling with depression, their fuse or that tank is gonna be a lot less. And so you might notice not just irritability, but then these kind of outbursts of anger or more significant frustration that weren't, that maybe had been present once in a while, but now seems to be more consistent. Maybe those outbursts aren't necessarily more frequency, but maybe the duration now seems to be lasting longer. Whereas your kiddo could kind of recover from getting frustrated or angry, say within, I don't know, 10, 20 minutes, but now it seems like that goes on for 40 or more.
Megan Spencer:
Or even they don't have the same ability to bring themselves back down to kind of that normal level of functioning. But then it also could be where your kiddo is, you know, expressive and right, we're human, so we're supposed to experience emotion, but it could be even that like their emotions or their expression seems to be very blunted or decreased, that it's almost that there's, there's no emotion, right? That they're kind of just neutral when typically they could be more excited and more happy about things and now that excitement and happiness is just decreased or non-existent.
April Morris:
But yeah, I guess if we continue Megan, where, where you were talking about with that flat or super expressive, I mean, we could be looking for either end of the spectrum and I think about the self-esteem and the comments too that I'm looking for. I can think about kids to say, "I'm not, I'm not good at anything. Nobody wants to play with me." Maybe there's some all or nothing, just really negative mindsets could lead us to, to wanna ask questions about, you know, how often they feel that way in particular areas that that's happening in.
Megan Spencer:
Totally. Or even maybe just, you know, talking about kind of feeling hopeless for school when they usually are pretty, you know, motivated or tend to be more positive or maybe making comments about how they're letting their friends down all the time. Where if they're playing sports and they're just feeling like, I'm, you know, I'm hopeless, it's, I'm never gonna get better at this and I'm letting my team, right? So it's, we're not just looking for, it's not just assuming that you're gonna notice very obvious mood changes or very obvious behavior change, that these could also be more subtle, but consistent, right? So it's what we keep kind of saying is a change and consistency. But the other thing I think I wanted to mention is also when we think about the Eeyore, this also brought up kind of your kiddo or adolescent that, you know, we think of anhedonia or a complete loss of interest in things that normally they enjoy, but maybe it's not so much a loss of interest, but you notice their ability to persevere or how they, how they seem on, say, on the soccer field, right?
Megan Spencer:
Or on the basketball court when they're usually full of energy and motivated and they're going after the ball and they're committed. You might notice just a kind of, just a change, not necessarily in the fact that they'll do it or not, but how they do it, if that makes sense.
April Morris:
Yep. No, that completely does. And that's a good point because we can't look at this as a "not there" or "all there" scenario. So it is tricky. I was thinking too about sleep and nutrition can be, can be big or can be subtle, you know, maybe they're starting to to sleep in more but still not rested. I know that can make a difference on how old they are, what's age appropriate sleep. Yep. But something to, to keep in mind may not be big and drastic. And then there is big and drastic where they don't wanna maybe get out of bed and, and do stuff and aren't excited to do stuff.
Megan Spencer:
And too, I think sometimes that big and drastic, that, actually that really is huge because I think sometimes even within ourselves, right, is that we, we don't notice the more subtle or small changes when we should, which then can eventually lead right to more significant issues. So I think really the just of this is, is don't always look for big huge changes or big, huge, you know, differences. It, they could be many smaller subtle things that it's, it's truthfully an awareness, right? It's not about being a therapist, a psychologist, it's truthfully more about awareness and recognizing that something is different and paying attention to how that is different and how long it's been different. I also think about physical stuff. So a lot of times, whether it's kiddos or adolescents, and we've talked about, maybe they don't have the words to explain it or maybe they don't, you know, totally understand their internal process. And so maybe this is coming out more in terms of physical complaints, like frequent body aches and pains, feeling like they, they just can't get their legs to move, right? They feel heavy, they feel weighted down. Maybe they're having, you know, headaches, stomach aches, but we, but also it could be, right, that manifestation into a more physical, physical complaint versus the mood or crying frequently or right. The things that we've kind of already mentioned. So I, there is also that piece too of the physical.
April Morris:
Yep. And I, you know, I think one of the symptoms we have left that we haven't talked about is the concentration. And I know that there can be overlap with other things, but again, if they just can't concentrate, whether it's loss of interest, the headaches, there's a lot of reasons why they maybe feel like they can't. But lack of concentration is, is something to, to keep an eye out for.
Megan Spencer:
And indecisiveness, I think that also sometimes we forget the piece of, you know, obviously kiddos and adolescents and aren't supposed to know exactly what they want and how they want it, but this can look like just even basic to what shoes they're gonna wear or what pants they're gonna wear when they're normally pretty, you know, quick or good about making decisions just on those very basic kind of, not higher order thinking, but just making basic decisions might start getting difficult for them. Or when they usually are given a couple choices at dinner and they can say, yep, I want this or no. And now it's kind of like, well I don't know what I want. I don't know what I feel like, I don't even know if I'm hungry right? It's, this can look so many different ways that it's, it's important to have that awareness. So yes, concentration, attention, difficulty, sometimes making decisions. It could also be, you know, when they're usually pretty focused, all of a sudden everything is distracting to them and they're getting frustrated when they're interrupted and right. It goes back to that fuse, that tank and that ability to tolerate what is happening in their environment versus, you know, home, school, at a friend's house. Those, those other pieces too. Definitely.
April Morris:
Well, and I think that kind of segues us into what all can create the symptoms and what's all going on and the causes if you will, but I guess different reasons why these things can occur, right? And so you're talking about environment and whether it's home or school, they're not feeling safe in that environment. They're not feeling comfortable. So whether it's the safety or comfort, our, our self-esteem is built out of our environment and depending on what is all occurring and, and being said and interpreted at home, how are we performing at school? Is, you know, school academics hard, are we having hard peer interactions? So all of these home and in school environment factors, these stressful factors can lead towards those depressive symptoms.
Megan Spencer:
Well, and we think like not feeling safe, right? And, and so when I hear that I, my brain is like, okay, I don't want people to go to like the worst case scenarios, right? Not feeling safe could just be, I got in a really big fight with one of my best friends and I'm just fearful that if I go back to school and interact with her, I'm gonna say something that's gonna make it worse. Right? So they have to think about safe in many ways too, and not just necessarily like our, our physical safety, but we have to think about that emotional piece. And then my brain goes straight to bullying, right? And not that all bullying is in many different forms, obviously, but even if it's not what we think of as really significant or severe, the perception of that kiddo and adolescent is really what is the most important versus what is the actual thing that's occurring or happening.
Megan Spencer:
So yes, that home-school environment, feeling safe, feeling comfortable, or even, even if it's not necessarily comfortable having the knowledge that there is a safe place to go within school or my teacher is a safe person to go to the environment clearly is, is a huge piece here. And then it's the relationships, not just with peers but relationships with siblings at home too. If you have a particular sibling that might be going through something, whether it's mental health or physical medical, that can also create an environment that might be stressful. Maybe it's, it's stressful because you're concerned about their health. Are they, are they gonna be okay? And so, right, we get, there's so many different things that this could entail when we say home environment, whether that's school, home, even a grandparent or a friend's, I mean this, that's a huge piece, but that relationship is part of the environment.
Megan Spencer:
And then if you think of stressful life events, right? Which kind of, yes, could this be a situation of bullying at school, right? Could it be repeated stressful events over time? Could it be one very significant or stressful event as perceived by that particular kiddo or adolescent? Yes. It doesn't have to be multiple things. It can be one thing that triggers a process within that individual that might lead to some of these things that we're talking about in terms of signs or symptoms and so stressful life events, oh gosh, I mean this goes lots of different ways. It could be they tried out for a sports team that they were really, really thought that they could make and they don't make it or they get cut. Or it could be that they have, you know, studied so hard for the, oh gosh, what are they now? Gres I think that I'm probably aging myself, but
April Morris:
The ACTs. <Laugh>
Megan Spencer:
You know, that they prepared so, so hard for that and they get their score back and it just devastates and it leads to the spiral, right? It could be that, I mean, their favorite teacher reprimands them one day and they take it very personal, I mean there could be so many different stressful life events of course. And then the obvious of, you know, maybe there's a fire at home or, or you know, some sort of flooding or a natural disaster. It, it could be that a parent has, you know, a medical condition where they're in the hospital or not even life threatening but still that they're removed from the home and they're going through a process of recovery.
April Morris:
And I'm just thinking like, you know, like how you clarified safety, it's like, you know, defining stressful. We just wanna make sure that we're not looking at just the big events. It's still their perception. It might just be that their friend wouldn't play with them all week. That led into, you know, it's not always bullying, it can be just a sequence of these other events that they find stressful.
Megan Spencer:
And then we have to think about not just physical illness of somebody in their life but their own physical illness. Just because their kiddos are adolescents doesn't make them immune from having different types of medical or, or even different types of pain issues. And honestly, there's, we think about growing pains, right? And I can remember in school, you know, shin splints from sports and I remember just having various, you know, body aches and pains from growing and yeah, although my perception was, oh this is temporary and yeah, this is just a part of growing, but that was my perception and maybe someone else can take those pains that are happening. And for some it can be a lot more severe than other kiddos and adolescents. So we have to then think even to some degree on normal growth and development, how that in and of itself could cause varying stressors and issues that could lead to kind of that spiral and the thought process and mood, obviously being in this part of the country, vitamin D. But to be honest, now that I'm looking at other research, even states that we would think have abundance of sunshine, they're finding that even those individuals are having some deficiencies in vitamin D too. Obviously not the sole cause but certainly relevant.
April Morris:
Yeah. And I think any of these physical conditions that we could use as examples just kind of go to, to speak to the way we assess for mental health. And we wanna make sure that people are staying on top of their, you know, primary care pediatrician visits talking about that growth and development, talking about symptoms that they're noticing to rule out medical physical medical conditions first because we wanna make sure there aren't thyroid conditions. We wanna make sure you know, that we don't have vitamin D or anemia issues cuz all of those things can look like depression with sleep problems and fatigue. And, and so we wanna make sure that we're looking at those and ruling those out first. And so it just kind of continues to support holistic all healthcare, mental health, physical health really do still need to continue to stay together.
Megan Spencer:
Too, and I think, you know, it's relevant also when we think about physical illness, even things that can be diagnosed in kiddos and adolescents but are manageable right? Could still lead to these types of, of mood fluctuation and behavior changes. So diabetes, right? We know that some kiddos and adolescents are diagnosed with type one diabetes fairly early and even though, right, it's 2022, we've got lots of information, we know lots of stuff for treatment and success, that still doesn't mean that that kiddo or adolescent who gets that diagnosis and has a great treatment plan that they still might not experience what these signs and symptoms are for the simple fact that this is something they're gonna have to deal with for the rest of their life, right? Yeah. What we think about epilepsy and seizures, again, not super common, but not super uncommon and we might think about this is again, like, yeah, we've got lots of knowledge, we've got lots of research, we've got lots of treatments, but that still again, doesn't mean that that kiddo adolescent is going someplace else in their head or, or thinking about things in a way that's, that's leading to mood and behavior changes.
Megan Spencer:
Even though it's something that can be treated and there's a great plan in terms of how it will be treated,
April Morris:
Definitely always consider that adjustment to any new diagnosis because that makes them potentially different from their peers and, and changes their capabilities at time of what they can and can't do. So definitely good to keep in mind. And I think what goes along with that physical assessment that we talked about is making sure that, you know, a medication isn't also causing some similar symptomsor worsening symptoms, you know, to keep your primary care provider in the loop onagain, as a rule out. And then there is always that typical are alcohol or drugs involved? That, that could be showing us these, these symptoms as well.
Megan Spencer:
And that can be a trickier one to have a conversation. I mean, kiddos I think obviously aren't immune from getting involved in some of these things, but when, you know, when we talk about alcohol and drugs, it certainly I think tends to be more common in the early teen adolescent years. And so I know for a fact that this is a topic that can be difficult for parents to talk with their kids and their teens about, right? So in all reality, yes, we know clearly drinking age is 21, but I think we're all aware that there is access far before that age as well as other types of substances. And so if we are noticing some of these signs or symptoms, right? We have to, as, as parents and caregivers do, not just awareness of what the signs and symptoms are, but kind of an, our own little quick and dirty assessment of what the heck is going on, right?
Megan Spencer:
So it's sitting down with your kid and saying, I understand you're, you know, you're in 10th grade, I get that there's a lot of stressors and things going on, but it's, it's really just being very explicit on asking, you know, have you, are you drinking right? Have you, have you tried marijuana or tried other drugs? Is that something that has been affecting you? Or, or right. It's, it's opening up that line of communication specifically as it relates to the alcohol or drugs. And even maybe before as just like a point of touching base with your adolescents is that, hey, you know, I know this stuff is available and I know it's out there, but let's talk about not just the fact that it's illegal, but how this could affect your mood and could affect your behavior and your friendships with peers, right? Is we have to take these conversations in as many directions as, as we can with these kiddos and adolescents because that's truthfully how they're gonna understand versus have their own preconceived ideas of what this stuff is and how it can be helpful versus not.
Megan Spencer:
I guess the, anything else on the alcohol or drugs or, I was gonna mention the, I think lastly we're all to some degree aware of the genetic piece. I always will always say though, genetics doesn't equal anything. Certain, certain psychiatric disorders have different genetic loadings, right? Where some tend to be more genetically inherited versus other, but even if you have a genetic history, it still does not mean, one, your kiddo has it, or two, that kiddo or adolescent will get it. But it, it really is just a point of awareness again and understanding that if that genetic component exists within your family, that it does statistically give a higher chance of developing that particular disorder. But that is in, in combination with these other things that we're talking about, environment support system, right? So the genetics is important to understand and be aware of, but it is not an equal.
April Morris:
And you know, obviously when we're talking about depression, you know, we, we need to touch on suicide and, and that's another hard topic, right? Sometimes asking or watching for suicidal ideation comments or behaviors. But it is super important that we do that. A lot of times you might see those, those comments about hopelessness. I'm, I'm never, or this is never gonna get better, I'm never gonna have any friends. It might start to, to actually lead to talking about suicide and making suicide comments, which we wanna take seriously and, and have conversations about it.
Megan Spencer:
The other thing too, I just thought of with that when you mentioned kind of that focus on death or dying, maybe it's there not, it's not so much verbal, but maybe in terms of art or things they're watching, whether it's movies, TV shows, the focus shifts, right? To more things about dying or death or not being on earth, right? So we have to think about that focus not just in verbal, but also could be in other ways such as artwork or writing, right? Some kiddos, adolescents love writing poems or writing stories and so, and then they'll share that, right? What is the content or how has that content shifted or changed in the direction of death or dying or suicide or not wanting to be around? So that was the other thing I kind of just thought of too, is not just verbal. This could be portrayed in a not obvious way.
April Morris:
Absolutely. And I, I can think of a 15 year old girl I was seeing and this, our conversation was hard to pull. She would say she, she felt hopeless and, and didn't wanna be here, but her art and her rewriting song lyrics, rewriting poems that she felt spoke to her were really insightful and gave me then direction on trying to clarify how much did she relate to some of these lines since she didn't have a lot of the words to describe how she was feeling. So yes, art, poetry stories, very relevant places for information.
Megan Spencer:
So engagement from caregivers parents, right? We can't just be engaged in what is verbal, what is obvious, but those secondary or not so obvious signs that could tell us what we need to know, just not in the way that we think we will know them. I think another one could, could kind of related to kind of that change in kind of behavior in a sense is, is giving away possessions or not all possessions, but maybe it's like one thing that they really love or they always hold onto or they, you know, has always been a source of comfort all of a sudden now they wanna give it to their best friend or their sibling, right? So again, it doesn't mean all of their possessions, right? It could be one or two very important things.
April Morris:
Any of these things that we're mentioning as far as suicidal comments or behavior are all just kind of should be taken as flags and more conversation and monitoring because it is tricky. They don't all have to be there, it be a variation of some of these things that we're talking about, but they definitely should raise a flag for more conversation.
Megan Spencer:
You know, and then I kind of just go back to that, the risk taking kind of self-destructive behavior. So when, when I, when I read or hear risk taking self-destructive behavior, that doesn't just mean alcohol or drugs, right? This could be totally different. This could be a kiddo or an adolescent who is usually quite thoughtful about who they talk with or thoughtful about, okay, well if I go to this friend's house and starts getting dark out, right? So it's, it could be really just a difference in not being thoughtful about their safety and, and just things that usually we don't think of. So even, you know, I think about situations that could be as it relates to sports or other types of, you know, where they're, you know, we think of self-destructive as like physically harmful, but self-destructive can also be emotionally harmful. So, we're, it kind of goes back to the anhedonia piece or, or you know, loss of interest in things, but maybe it's, it's also about removing themselves from the things that reward them. So it's not so much sports related, but it's usually when, you know, every Friday they get together with their friends and now they, you know, they don't wanna necessarily get together with their friends or they start being, you know, fighting more or nitpicking things and just getting in arguments and just being more destructive to their own relationships in that sense. If, if that, am I making sense?
April Morris:
Yeah, I can think of maybe a couple examples that could be helpful too. I have a guy that knew when he spent time with his roommate or if his roommate was around, he was less likely to engage in suicidal thoughts or behaviors. And so if he was really like, no, I'm, you know, I need to spend less time with him because I, you know, otherwise think that this is what I want. And it was just kind of interesting that they might try to separate themselves from friends or people that could change their mind, if you will. And of course we're trying to encourage them to stay around people that care about them cause it is a good reminder of why we might want to remain here and stay here.
Megan Spencer:
That makes me think too, even a change in friend group, right? To a tendency towards peers that are more destructive or engage in more, you know, risk taking behaviors, whether that be in school or out of school. And so write that change in your friend group, not necessarily removal of social activities, but a change in the ones you are spending time with.
April Morris:
And I had a girl that was really honest, like, well, I don't wear my seatbelt because it's kind of, it happens, it happens. And so she was by no means trying to prevent death but also not necessarily seeking it out. And that was just a really gray area for us to continue to work through.
Megan Spencer:
But I think that's a good example, right? Like these kind of more risk taking, destructive behaviors don't have to be as obvious all the time. It's just taking a second in time to think through what's, what your kiddo said, what they're doing, what's different. Obviously self-harm, right? This goes and, and so self-harm relates to, you know, things we directly ask about self-injurious behaviors, cutting, burning are some of the more obvious would be something to think about. Again, doesn't none of these equal anything they just warrant, right? Attention conversation, awareness,
April Morris:
Right? And just in, I know I'm usually the one watching time, Megan, we got about 10 minutes for all the stuff that we wanna talk about.
Megan Spencer:
Okay, <laugh>. So the only thing, other thing I wanna mention about suicide is the, the only other piece that I think isn't as common is the kind of sudden reversal, you know, when your kiddo they may already have been diagnosed with depression and they've been kind of in an episode, things have been pretty down and then all of a sudden kind of, it's not like a total change, but like there's just a reversal of that outward appearance, right? They might kind of all of a sudden just seem more upbeat or more motivated, but it was like, okay, but yesterday you were, you seemed, seemed this way, but it's just this outward reversal of what seemed so off compared to what was usual for the last few days or weeks. If that makes sense.
April Morris:
What about when we were talking about the different, and, and we didn't wanna get into a lot of detail, but relevant to mention, you know, with depression symptoms, you know a therapist or a medical provider is gonna be looking at, you know, is there a prolonged grief? Is it a grief reaction? Is it, you know, trauma? Is it seasonal depression? You know, we have different types of disorders that encompass depressive symptoms. So, you know, it's just important if you're recognizing any depressive type symptoms that you are reaching out to have it further assessed because we, we may not really knowuntil that happens.
Megan Spencer:
And kinda lastly briefly, I won't try to talk too much in depth, but I think it very much is relevant in terms of females and adolescents to mention the premenstrual dysphoric disorder. Those depression symptoms can be tied to the hormonal cycle, right? And so when we think about depression in terms of the menstrual cycle and hormones, these are gonna be some of the same signs and symptoms that we already talked about, but specifically occur the majority of the menstrual cycle, right? And then they start to improve within a few days and then become kind of minimal or absent after the period or the menstrual cycle has ended. Here's where we have these signs or symptoms, but very much more focused around the hormonal menstrual cycle versus unrelated. So that's just a piece I really wanted to make sure we mentioned because that I don't think is talked about as much, but absolutely that hormonal change in the menstrual cycle can cause legitimate depressive symptoms and episodes in a, in as it relates to the hormonal fluctuation.
April Morris:
Yep. Absolutely. And I like that you bring that up because I, I don't think it's diagnosed a lot and it, and I think it takes a little while to catch onto it. So I think we all should be kind of aware that that is a possibility. And just in general, a lot of our talk today right, is about looking for signs and symptoms and potential stressors and causes, but you know, most importantly it is gonna be can we talk to our kids about it? Can we, can we talk about emotions and just normalize periods of sadness, but also help weed out when it, it might be problematic and impacting areas of our life, right? Not getting stuff done at home, our social life, work, schoolI suppose teenagers include work, but all those areas and, and being able to kind of normalize getting help and support and what that support looks like.
Megan Spencer:
And I think the more that us as parents and caregivers normalize this, what, when we say normalize, we mean like, talk about it. Talk about that this isn't something that nobody experiences, that this is common and we're humans and we're supposed to experience changes in mood and feelings and emotions and stresses are natural. It's how we, right? So it's the awareness. It's having those conversations even when you don't think something is going on, but open that line of communication that's saying, Hey, here's, you know, here's what, here's what depression is. And I know, you know, we all struggle with sad and, and down moods, but if you're ever feeling like this or like that, please come talk to us, right? Or, hey, if you feel like you want some support, you wanna see the counselor at school, you wanna talk to somebody else, that's, that's okay. Right? Normalize means talk about it.
April Morris:
And I think to reiterate some things that maybe we've heard elsewhere, but helping make sure our kids get a healthy amount of sleep and nutrition and exercise impacts our mood. We know it can help with depression, keeping open conversations with primary care pediatricians and just reach out if you think it, it might warrant an assessment. I'd err on the side of caution and conversation then, you know, wait and wonder therapy and or medications, you know, can make depression treatable. So wanna make sure that We leave question time for you guys too. But did I miss anything?
Megan Spencer:
I don't think so. I think it normalized through conversation, talk about it, talk about options, whether you think there's a problem or not. That lots of, lots of kiddos, lots of adolescents, lots of adults see therapists, they, you know, sometimes it's frequent, sometimes it's not. It's, it's really, I think overall just providing an environment for which your kiddo and adolescent feels comfortable enough to say if something's going on or you've created the environment where you can bring that up to your kiddo and adolescent. The other piece I just thought of is, okay, when do you get help? You get help when you start noticing these signs or symptoms, when you start noticing that these changes have become more long standing, right? It's not a day or two and then they kind of snap out of it, right? This is like a week, two weeks, maybe there's a day change but it kind of falls back into those signs and symptoms that have been different. So when to get help, there's no right or wrong, it's, it's just if we are noticing a more consistent change and we've talked about it or we've tried to talk about it, that's there, that's kind of when right when you notice it, when it seems consistent, more endearing.
Randi Streff:
Well thanks everyone for being here. I think I just wanna say one thing really quick cause I think it's important as a parent, as a caregiver, as someone who might be with the kids here at the ranch or in any other sort of role where you're, you know, coaching or youth group or anything like that. As adults we're children's advocates and so if you ever feel like something is going on with kids, with a teen, with a child, with anything like that, just remember that they might not have someone they can talk to about it. So if you're a person in their life who they might be able to talk to, let them know that. Make sure that they know that
Megan Spencer:
That is a great point. Yeah. Open the door, right? Allow the door to be open for if they choose to walk through it.
Randi Streff:
Yeah. Oh, thanks everyone for being here. Have a great weekend and hopefully we'll see you next time.
Tammy Noteboom:
Thank you for listening to this Community chat presented by Dakota Family Services. To make an appointment with one of our mental health providers or to learn other ways to mind your mind, go to Dakota family services.org.
People tend to perceive risk as being inherently negative. But for teenagers, risk-taking is a healthy, normal, and important part of growing up. In this episode of Mind Your Mind, Host Tim Unsinn talks to Vanessa Lien, Nurse Practitioner, about creating a safe environment for your teenager to take risks—and knowing when to step in when they start taking risks that could result in serious and long-term negative consequences.;
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In today's episode of Mind Your Mind, your host Tim Unsinn talks with Christy Wilkie about the Feelings Wheel*. Christy, a therapist at Dakota Family Services, says humans experience 34,000 different feelings! She demonstrates how to use the Feelings Wheel to help you identify your emotions so you can control the behaviors associated with them. *Adapted by classtools.net from the Emotional Wheel. The Emotional Wheel was developed by American psychologist, Dr. Robert Plutchik.;
In today's episode of "Mind Your Mind," Vanessa Lien, Nurse Practitioner, talks about the many changes occurring in the teen brain. The teenage brain is highly susceptible to stress, but it is also very resilient. Learn coping strategies you can teach your teen to protect their brains and help them cope with stress and emotional struggles.;
Going back to school after summer vacation can be a stressful time for both kids and parents. The transition from the unstructured summer to a more regimented routine can lead to stress and anxiety. Worries about fitting in, bullying, homework, getting to school on time, and dealing with peer pressure are all additional stressors that may weigh on children when it's time to go back to school. In this episode of “Mind Your Mind,” Tim Unsinn speaks with Therapist Falan Johnson. Falan helps us understand why back to school anxiety is common, provides strategies for managing the added stress, and shares resources parents can use to prepare their children for the new school year.;
The grief of losing a friend or loved one to suicide is complicated and can be especially difficult. In addition to the grief, sadness, and loneliness of any loss, people might experience guilt, confusion, rejection, anger, and shame. The stigma of suicide complicates it even more, often preventing survivors talking about their loss or getting the help they need. In this episode of Mind Your Mind, Tim Unsinn visits with Dakota Family Services' therapist, Christy Wilkie. Christy helps listeners understand the complicated nature of suicide grief and how to move through it with compassion and self-acceptance.;
You will be shocked at the seemingly safe places predators can connect with your children online. In this episode of Mind Your Mind, Lucas Mitzel, a therapist at Dakota Family Services, talks about the things you need to know to keep your children safe. Learn the many websites and platforms used to target children, how to monitor their internet usage, and how to talk to your children about the dangers.;
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Anxiety and depression are invisible illnesses—meaning they don't have outward symptoms visible to others. Because they are invisible, they are often hard for people to explain. In this episode of "Mind Your Mind," Host Tim Unsinn visits with April Morris, LCSW, Therapist, Dakota Family Services. April references the spoon theory of chronic illness created by Christine Miserandino, an award-winning writer, blogger, speaker, and lupus patient advocate. Listen now to learn more about spoons as a metaphor for energy and how you can use them to understand and explain anxiety and depression.;
While we hear a lot about autism in the news, many of us still have misconceptions about its causes and symptoms. In this episode of Mind Your Mind, therapist Falan Johnson dispels some of these misconceptions and explains the three levels of autism. Johnson then focuses on the least understood level—high functioning autism. Learn how to identify symptoms of high functioning autism in your child, the importance of early intervention, and ways you can support them.;
In this episode of Mind Your Mind, therapist April Morris talks about boundaries. April will define boundaries, explain their importance, and help you set boundaries that match your values and strengthen your relationships. Learn how healthy boundaries can improve your mental and physical health, and how you can say “no” respectfully.;
Going through infertility tests and treatments can be an extremely difficult and lonely time for couples. In this episode of Mind Your Mind, Lucas Mitzel talks about his own experience. He also shares tips for couples struggling with infertility, and for friends and family members who want to be supportive but don’t know what to say or do.;
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Unsure of whether your therapy is working for you? In this episode of “Mind Your Mind,” our host Tim Unsinn talks with Dakota Family Services therapist Lucas Mitzel about how to make your therapy sessions more productive. Making progress in therapy can often come down to simply having an open mind and a plan for discussion. Although each session can evoke a wide range of emotions, you should always leave feeling that some sort of movement has happened.;
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In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinson discuss autism and signs of it in children, touching on the different levels of the autism spectrum and where people fall. Learn about how autism often affects children's social skills, communication, and behavior, as well as its connections to other disorders and how to handle it.;
Many people find themselves dealing with high levels of stress and anxiety in their daily lives. However, there are plenty of simple strategies to help regulate these emotions. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist Sandy Richter about various coping exercises to help you regulate and calm yourself, including breathing and movement exercises for both children and adults.;
Medication can affect people in many different ways. In this episode of Mind Your Mind, host Tim Unsinn and psychiatric nurse practitioner Amanda Daggett talk about genetic testing and its use in discerning how different individuals might react to various medications. Tim and Amanda also touch on some of the facts and myths surrounding genetic testing, including what testing can and can’t indicate and where the science is currently at.;
Anxiety is one of the most common mental health problems people face. However, there are many ways to manage and understand it. On this episode of Mind Your Mind, host Tim Unsinn and therapist Lucas Mitzel discuss what causes anxiety and how it can affect people’s day-to-day lives, as well as the difference between anxiety and fear and how to combat chronic anxiety with grounding techniques.;
In this special Community Chat episode of Mind Your Mind, Psychologist Megan Spencer and Psychiatrist Wayne Martinsen discuss how loneliness and social isolation are increasing in our country, as well as what that means for individuals’ health in the long term. They also give advice on how to get yourself or your loved ones more connected with others, including how to connect both in-person and online.;
Does it seem like your child is “stuck” in therapy, or engaging in dangerous behaviors like self-harm and suicidality? In this special Community Chat episode of Mind Your Mind, Psychologist Hannah Baczynski and therapist April Morris discuss Dialectical Behavior Therapy and its effectiveness in treating patients who have found traditional therapy unsuccessful. Learn about the 4 core skills of DBT and what makes DBT unique from other forms of therapeutic treatment.;
When our children are struggling with their mental health, it can be hard knowing how to help them. However, in addition to therapy, medication can be a viable and effective option for improving your child’s mental health. In this episode of Mind Your Mind, our host Tim Unsinn talks with psychiatric mental health nurse Amanda Daggett about how to know if your child needs medication, what the process is for a prescription, and how to tell if their medication is right for them.;
Did you know that depression occurs in about 15% of children? In this episode of Mind Your Mind, our host Tim Unsinn talks with Psychiatrist Dr. Wayne Martinsen about depression in kids and adolescents, including signs of depression to look out for and how to know when to reach out to a care provider. They also touch on how to know whether your child’s sadness is caused by depression or other external factors and what you can do to try and prevent depression in your child.;
Humans are hardwired for social connection, but it can be difficult knowing where to fit in as unique individuals. In this episode of Mind Your Mind, host Tim Unsinn and therapist Christy Wilkie talk about the importance of using your strengths, interests, and relationships to figure out where you belong. They also touch on signs that you might not be staying true to yourself, as well as how to handle feelings of being left out.;
While often perceived as only relating to those who’ve experienced warfare, Post-Traumatic Stress Disorder (PTSD) can affect anyone. In this special Community Chat episode of Mind Your Mind, Psychologist Dr. Hannah Baczynski and therapist Lucas Mitzel explain what trauma is, how it affects each person differently, and when to seek treatment for trauma-related symptoms. They also discuss different treatment options for PTSD, touching on the pros and cons of each.;
Though autism is one of the most commonly discussed mental health diagnoses in the community, it is often one of the most misunderstood. In this special Community Chat episode of Mind Your Mind, therapists Lucas Mitzel and Falan Johnson discuss what autism is, how it appears in children and adolescents, and how it may look different between individuals. They also touch on how autism can show up differently in boys than in girls and offer intervention tips for parents and caregivers.;
Autism is sometimes perceived as a disorder that only affects children and adolescents, but it is actually a lifelong diagnosis. In this special Community Chat episode of Mind Your Mind, psychologists Dr. Hannah Baczynski and Dr. Megan Spencer explore the symptoms and nuances of autism in adults, touching on the history of autism spectrum disorder, the research surrounding it, how autism commonly presents in adults, and more.;
Though spirituality is often associated with religion, it can mean much more than simply attending religious services or praying. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen define spirituality and discuss its relevance in daily life, touching on ways people experience, express, and cultivate spirituality. They also talk about the link between spirituality, religion and meaning in life.;
Setting goals is easy. Working towards them is hard. In this episode of Mind Your Mind, host Tim Unsinn talks with Dakota Family Services therapist Christy Wilkie about how to set healthy, realistic goals, as well as the importance of managing your expectations and staying persistent. Whether you’re starting an exercise routine, writing a book, trying a new diet, or building your career, keep these tips in mind when setting your next big goal.;
Fear is powerful. It can cause us to avoid problems, people, and even opportunities in our life. But it can also be overcome. In this episode of Mind Your Mind, host Tim Unsinn speaks with Falan Johnson, a therapist at Dakota Family Services, about the function of fear and how to face it. Learn where fear comes from, how to identify it, and how to calm down and build confidence when you’re feeling afraid.;
In this episode of Mind Your Mind, our host Tim Unsinn talks with Dakota Family Services therapist Jessie Mertz about the “3 R’s”—Regulate, Relate, and Reason. They discuss what each term means, how they build upon each other, and how this approach can help you calm others who are experiencing distress.;
Schizophrenia is a chronic, complex mental health disorder that affects around 1% of people in the United States. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen discuss the symptoms and implications of schizophrenia, touching on its many effects on individual and family life. Learn about how schizophrenia is treated, how it affects physical health, when it tends to develop, and how it is perceived between cultures.;
Although the stigma surrounding mental health is gradually disappearing, it can still be tricky knowing how to talk about it. In this episode of Mind Your Mind, host Tim Unsinn and psychologist Megan Spencer explore how to have a conversation with someone about their mental health, including signs that you should talk to them, how to start the conversation, and some possible reactions to expect from the other person.;
Are you feeling cooped up indoors? Join host Tim Unsinn and therapist Lucas Mitzel in this episode of Mind Your Mind as they discuss the importance of getting outside on your mental health. Learn about the benefits of green and blue spaces, activities you can do while outside, and how being outside can help improve symptoms of different mental health diagnoses.;
In this episode of Mind Your Mind, Tim Unsinn talks with psychologist Dr. Hannah Baczynski about the signs of burnout, how to prevent it, and how to know if your burnout is related to general life stressors or a mental health disorder. They also talk about the difference between fatigue and burnout, as well as how to support yourself and alleviate burnout when you’re experiencing it.;
Many of us know someone who has been diagnosed with a chronic illness, or have been diagnosed with one ourselves. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how chronic illness can impact daily living and mental health, as well as how to seek support if you have been diagnosed with a chronic illness.;
Although the term ‘bipolar’ is sometimes used as slang to describe someone who is moody or indecisive, true bipolar disorder is a complex and sometimes severe mental health disorder that affects the way a person thinks, feels, and behaves. In this episode of Mind Your Mind, host Tim Unsinn discusses bipolar disorder with nurse practitioner Amanda Daggett, touching on what the disorder is, what its symptoms look like, and how it can be treated.;
How much time do you spend each day looking at your phone? An hour or two? Multiple hours? In this episode of Mind Your Mind, host Tim Unsinn meets with therapist Christy Wilkie to discuss how social media use can impact our mental health, relationships, and behavior. Learn tips for monitoring your child’s internet use, as well as how to manage your own time spent on social media.;
While OCD is sometimes perceived as simply a desire to keep things neat and organized, it can actually have much more severe symptoms for those who experience it. In this episode of Mind Your Mind, host Tim Unsinn meets with psychologist Dr. Megan Spencer to talk about who Obsessive Compulsive Disorder affects, what its signs and symptoms are, and how to seek help if you or a loved one has been diagnosed with OCD.;
Bad habits can be easy to start but sometimes very difficult to stop. In this episode of Mind Your Mind, host Tim Unsinn and therapist Falan Johnson talk about breaking bad habits, including where habits come from, how to know if a habit is bad, and steps you can take to stop it.;
Are you looking for some help on your mental health journey? In this episode of Mind Your Mind, host Tim Unsinn and therapist Jessie Mertz talk about how to find a therapist, including what you should know when searching and what questions to ask when you meet a therapist for the first time. They also touch on what the letters after a therapist’s name mean, and how they apply to the type of services or treatment you might be looking for.;
Whether it’s from asking someone on a date or applying for a job, we all experience rejection at some point in our lives. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how to cope with rejection, including the common coping stages, the importance of acceptance, and how rejection can impact people differently.;
Like other personality disorders, borderline personality disorder is a commonly misunderstood and stigmatized mental illness. In this episode of Mind Your Mind, host Tim Unsinn talks with Lucas Mitzel, a therapist at Dakota Family Services, about what BPD is, how it affects someone’s behavior, and where to seek treatment if your child has been diagnosed with BPD.;
Do you think you might be suffering from an undiagnosed mental disorder? If so, a psychological assessment might be able to help. In this episode of Mind Your Mind, psychologist Dr. Hannah Baczynski and host Tim Unsinn talk about what to expect from a psychological assessment, including what an assessment might include, what information you might receive from the psychologist, and what you should communicate with your psychologist before and after receiving an assessment.;
In this episode of Mind Your Mind, host Tim Unsinn and Amanda Daggett explore the topic of using supplements for mental health. In addition to talking about some of the most commonly used supplements like melatonin and St. John’s Wort, they also discuss the benefits, the risks, and the research surrounding various supplements.;
Feeling like you’ve got the winter blues? If you’re noticing symptoms of depression with the change of seasons, it may be a sign that you’re suffering from Seasonal Affective Disorder, or SAD. In this special Community Chat episode of Mind Your Mind, therapists Christy Wilkie and Lucas Mitzel discuss the common symptoms of Seasonal Affective Disorder, how it can affect other mental health disorders, and some useful tips, tricks, and resources for managing symptoms of SAD.;
Join Christy and Lucas, therapists at Dakota Family Services, as they share practical tips for building confidence when trying new things. From managing self-doubt to building resilience, this episode will empower you to approach new experiences with a positive mindset.;
In this episode, Christy and Lucas explore why relationships can be so hard. Join them as they discuss the characteristics of both healthy and toxic relationships, talk about the difference between normal conflict and abuse, and help you discover your love languages so you and your partner can best express your love to each other.;
In this episode, Christy and Lucas explore anxiety. Join them as they discuss the signs and symptoms of an anxiety disorder, what you can do to decrease your anxiety, and how to best help loved ones struggling with anxiety.;
In this episode, Christy and Lucas explore depression. Join them as they discuss the signs and symptoms of Major Depressive Disorder, what you can do to help yourself feel better, and what you can do to help your loved ones. They will talk about coping strategies, therapy interventions, and ways to help you identify when your child might need extra help.;
Change is inevitable. Join Christy and Lucas as they explore big and small changes and how they impact you. Learn why change can be so hard, even good change, and discover ways to manage it effectively.;
In this episode of "Is It Just Me," Christy and Lucas discuss the very important topic of suicide. Listen to learn about risk factors, warning signs, and what you can do to help a loved one who is struggling. Remember, you are not alone. If you need immediate assistance, call 911. If you need to talk to someone, call the Suicide and Crisis Lifeline at 988.;
Join Lucas and Christy as they explore the power of spending time outdoors on mental and emotional well-being. Discover practical tips, personal anecdotes, and expert insights on the benefits of getting outside and reconnecting with nature.;
In this episode of "Is It Just Me?" Lucas and Christy discuss ADHD, shedding light on its prevalence and impact on daily life. Learn practical strategies for managing symptoms and understand why your friend or loved one with ADHD does the things they do.;
In this episode of "Is It Just Me?", join our hosts Christy and Lucas as they delve into the complex relationship between the internet and mental health. With the digital age bringing information and social connections to our fingertips, it also presents unique challenges and opportunities for our safety and psychological well-being.;
In this episode of "Is It Just Me?", Christy and Lucas discuss how common it is for people to see themselves differently from others. Using their own personal triumphs and challenges as examples, they outline the things that shape our self-esteem. Additionally, they share simple daily practices to help listeners recognize and celebrate their own personal victories. This episode is filled with tips and engaging stories aimed at encouraging listeners to undertake challenges that foster self-growth and personal confidence.;
In this episode of "Is It Just Me," Lucas and Christy talk about what it's like to begin therapy. Feeling apprehensive about starting therapy is normal, but surmountable. Together, Lucas and Christy unravel common myths about therapy and emphasize the role of therapy in disrupting negative life patterns and routines that are no longer serving you.;
In the latest episode of “Is It Just Me?” Christy and Lucas tackle the transition from leisurely summer days to structured school schedules with warmth and wisdom. This episode is a must-listen for parents seeking guidance and strategies to help navigate the shift with confidence. Learn how to handle changes in routine, the importance of communication, and strategies to help the entire family adjust to and embrace the new normal. Listening to this episode can be your first step toward making back-to-school a season of growth and positive change for all.;
In this month’s episode of the "Is It Just Me?" podcast, Lucas Mitzel and Christy Wilkie, Dakota Family Services, dive into the complexities of trauma and its therapy. The episode sheds light on Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and the importance of creating a trauma narrative as a cornerstone of healing. The thoughtful discussions aim to educate listeners on the intricacies of trauma, the innovative methods used in therapy, and the role of caregivers in the recovery process. Through expert insights and compassionate storytelling, Lucas and Christy provide practical advice and real-world examples for individuals who have experienced trauma.;
In this episode of “Is It Just Me?”, Lucas and Christy delve into the world of mindfulness and relaxation techniques. From body scans to mindfulness exercises, they provide a soothing experience to help you unwind and distress. Discover practical tips and advice on incorporating mindfulness into your daily routine and learn how to prioritize mental well-being in today's fast-paced world.;
In this special additional episode of “Is It Just Me” join therapist Lucas Mitzel as he gives listeners a transformative journey within their own body and mind. In this episode, Lucas guides listeners through a soothing body scan to promote calm, mindfulness, and inner peace. This episode offers a unique mixdown of gentle narration, and relaxation techniques, leaving you feeling refreshed, rejuvenated, and more connected to yourself.;