May is Mental Health Awareness Month, and Clare Waismann, RAS/SUDCC and David Livingston, LMFT are discussing the need for a greater mental health focus in our culture. Mental health is an incredibly important part of our overall health and it is time to come together and raise awareness on mental health issues. For too long, mental health has been shrouded in stigma and taboo, preventing many from seeking the help they need.
This month is about starting the conversation and breaking down the barriers that stand in the way of those living with mental or behavioral health issues. It is an opportunity to educate others about the signs and symptoms of mental illness, and to provide support to those who are struggling. By working together, we can help reduce the stigma and make it easier for those in need to seek help. Let us come together this May and show our support for Mental Health Awareness Month.
Dwight Hurst, LPC: Welcome back to Addiction, Recovery and Mental Health, a podcast by Waismann Method Opioid Treatment Specialists. I’m your co-host, Dwight Hurst. I’m joined today as always by Clare Waismann and David Livingston. May is Mental Health Awareness Month and there’s a lot going on at Waismann Method to promote that. You know, we tend to put everything in a question format and I guess the question, in this case, would be what is awareness? And, you know, how do we increase it? We can touch on a lot of different facets when it comes to mental health awareness. But yeah, it’s been it’s a it’s a big time. It’s a big focus right now for for everybody at Waismann Method, right?
Clare Waismann, RAS/SUDCC: I think for everybody in society, period. You know, I think especially in the United States right now, mental illness is just snowballing,and affecting every part of our society. And so having May as the Awareness Month, you know, gives us the opportunity of talking about it and, you know, letting the people know that. Until illness is treatable and there is help out there and there is no reason for them to for anybody to suffer alone. Mental illness has nothing to do with who they are or their personality.
It is often chemical imbalance or, you know, a combination of issues that is treatable, you know, and can give you a much better quality of life than you’re having right now. So reach out. That’s all. I think, not just those suffering from it, but those working with it can create some awareness in education, I think is really important. I think if people understand the roots of it, there’s going to be less stigma, less shame involved with seeking help.
Dwight Hurst, LPC: I was reading just recently about the increase in depression symptoms and depression disorders, and particularly this article was talking about amongst young people. And it addressed this thing where it said, although, although it’s an activating factor, the pandemic and all the attending things is that we may tend to overestimate that there’s a rise in depression even before that, and that there’s lots of components. And we have talked on here before about like like kind of social media and things like that, that can be agitators.
But to a certain extent, it’s just this feeling of, wow, you know, it’s on the rise. And mental illness is something that is becoming you know, it’s something that as we talk more about it, we become more aware that it affects everybody who’s listening out there, whether or not we have a biased sample with our audience. But anybody, whether listening or not really, if you know, and if you’re paying attention, you get someone in your life who’s has some mental health struggles.
And then not to mention the situational depression and trauma that many of us feel, you know, as we recently talked about crisis and things, too. So there’s a lot going on with our mental health. It really affects everybody.
Clare Waismann, RAS/SUDCC: Yes. And I think there is a tremendous amount of misunderstanding in the topic, you know, that I think the more we talk about it, the more people understand about it, the more I think that we as a society will realize the need for more accessible mental health care period for society as a whole. Starting in, you know, great schools. And also understand that, you know, it’s not a bad gene. It’s not weakness. It’s. The condition that is mostly treatable.
Dwight Hurst, LPC: One of the things that’s very interesting about mental health is, first of all, I always think it’s interesting that when we talk about it, we talk about it as if it were separate, as if it were somehow not associated with the body. For example, I hear a lot of people use expressions or phrases like, I don’t know if this is physical or mental health. And it’s interesting because I mean, as far as I’m not a doctor, but the brain is contained in the body.
So mental health is physical health, right? I mean, you’ve got physical reactions in the brain that are responsible for those symptoms. And and people will say, well, is this medical or psychological? And it’s like, well, psychological is medical, you know.
Clare Waismann, RAS/SUDCC: Barack and a lot of illnesses, you know, a lot of conditions will affect the person’s thoughts, feelings, behavior, you know. You know, a lack of some nutrients can cause you to be anxious, and depressed, you know. And in the same hand, some mental illnesses can cause you to feel certain physical, you know? Effects as well.
So it’s you know, it’s not like our head walks alone. Our brain is connected to our system and is what controls every aspect of it. So if there is any, you know, misfiring of our brain chemistry, it’s going to affect every part of our lives, period.
Dwight Hurst, LPC: Absolutely.
David Livingston, LMFT: Right. Right. So there’s you know, and trying to bring about awareness is as a first step is really good that our biology that what we don’t do well with what causes problems is when our system is congealed. Right. So a lot of anxiety and depression when you sort of bear down into it is a congealing of feelings. So the feelings are not getting understood. You know, feelings are just information. That’s really all they are. The information is about who we are, how we feel, what matters to us, what doesn’t matter to us, what there’s what’s affected us and often difficult ways that we don’t want to feel.
And because we have a capacity to repress things, we can repress and create a congealing, that congealing ends up as the feeling of anxiety or depression, depending on what the feelings are and how a person’s nervous system is oriented and other factors. And so when you bring awareness to things or even better understanding, so awareness is the first part of it. But then when you actually can break things down and help someone understand personally and directly what’s causing the depression, the anxiety, and by the way, people I don’t care who you are, you’re going to have periods of that in your life knowing how to understand it, think about it, feel the feelings which allows them to become fluid again.
So a healthy system is a fluid system. And, and so just the beginning of bringing awareness to things, you know, has the potential of moving you towards that. You know, I was listening to a podcast by a neurobiologist and he was talking about how when there’s anxiety, one of the things that is so useful is just walking, just taking a step forward because it actually triggers to our nervous system and our whole system that we’re not in the fight or flight or freeze mode. And so kind of when I listen to kind of reaching out and doing this, I think, okay, let’s get out of that mode.
Dwight Hurst, LPC: It’s such an interesting thing to look at. Some something like the mental health system, the psychological health is that it’s very pathology-based. And to a certain extent, all treatment, I guess, is about identifying the organ failure or the problem. On the other hand. One of the things that that that is interesting is if you said to someone, you know, we’re going to take some tests about your heart health and you’ve never had a problem with your heart before. And your doctor just said, “Yeah, you know, you’re somebody, we should just take a measure of your we test your blood, we test this, we test that certain age. We test for prostate cancer or breast cancer. We just do it. We don’t say, well, hold on, I don’t have cancer health problems. You know, with mental health, we just identify it based off of a problem. Right?
Clare Waismann, RAS/SUDCC: Yeah. But that’s what I was saying about the misunderstanding, you know, of, you know, how complex and they know how it interplays, they know between the environment and biological factors. So I think, you know, trying to simplify it in not understanding it is what causes stigma. Even the language we use to describe it, you know, oh, that person is crazy. They’re psycho.
Dwight Hurst, LPC: Right? Right. It still ties very much with what we use as kind of insults or colloquial putdowns.
Clare Waismann, RAS/SUDCC: Correct. But that’s trying to, you know, simplify something that is not that simple. And the root of it could be one or multiple. And nothing that describes somebody’s, you know, personality or will, you know, of being or not being. It’s not something that you say to somebody, “Get over it.”
Dwight Hurst, LPC: Yeah. Yeah. You should just walk it off with that heart attack.
Clare Waismann, RAS/SUDCC: Right.
Dwight Hurst, LPC: Or even, you know, even the fact or the fact that that you do say walk it off ish or you do say go for a walk for your heart health. You know, I mean, that’s one thing I’m thinking that I think about a lot is we all exist on a spectrum of health of every kind of health our heart, our brain, you know, our feet. I don’t know. I could I don’t want to show off that. I can keep naming body parts. But the fact is we all are on a spectrum and we understand that usually.
But it’s like we all have mental health and to to look at it that way and say, you know, we’re all on the spectrum of mental health. We’re all somewhere. So how do we use I think that’s hopefully useful to fight the stigma of saying a mental health problem is a human health problem is the idea.
Clare Waismann, RAS/SUDCC: But I think the other way of fighting it is early intervention. You know, because we are so ashamed of it. Sometimes things are ignored, you know, and not talked about. And that’s when the problem spirals out of control. So I think if we make mental health treatment accessible, you know, and provide people the education they need, these are not going to get where they are right now, or at least they will stop from, you know, snowballing like they have the last decade.
Every part of our society that is affected by, you know, or mental illness has grown tremendously from homelessness, addiction, crime. I mean, think about everything that is affecting our society right now. I walk in Los Angeles. I have never, never seen the amount of mentally ill people just walking down the streets like I see nowadays. It’s daily. It’s everywhere. It’s tragic.
Dwight Hurst, LPC: What do we look at as some of the barriers to that? We talk about stigma, but if we’re to break that down a little bit and say what keeps people away? I mean, I know that access to treatment, you know, having a shortage of providers or often even bad experiences. I know we talk a lot on the show about some of the limitations of of some addiction treatments, but, you know that people have bad experiences with something that’s not run well or, you know, there are basically a lack.
You look at the amount of prescribing psychiatrists that are available who are specialists, that’s lower than it used to be. And so for me, that’s one thing that leaps to mind for me is even beyond stigma is the lack of access to care had the difficulty in finding care.
Clare Waismann, RAS/SUDCC: Well and yeah and I’m sorry, David, even for, you know, you’re talking about the middle class. So you go see a psychiatrist. You know, we see that over a lot of our patients. Psychiatry and mental illness is something that needs continuous care. But if your insurance stops paying after $1,000 or $2,000, you’re just going to see the psychiatrist for two or three times and that’s it. And then the care is over for those that, you know, can’t afford insurance.
There’s just not enough coverage for psychiatric care. That is the basis of everything. It’s fundamental that people, you know, have that support. And for those that do not have health insurance, then is nonexistent. So I think there is, you know, the shame of accepting that “I have a mental health issue” and. Secondly, there is the issue. If I do have a mental health issue, what am I going to do with it? I can’t afford to treat it.
David Livingston, LMFT: Right that’s certainly not always. Certainly not always, but. But more often, the more resources a person or family have, the better chance they are of getting an actually an effective treatment. And very rarely do people get effective treatments for their problems. And it’s not just the insurance or the medical system. It’s also finding the right fit, finding, you know, and the capacity to sort of really advocate for yourself and pay attention to whether things are getting better or not. And discuss with your clinicians, you know, whether things are resolving and to be able to sort of have that frame of reference.
I think that there’s a mode of being in which there’s a sense of kind of we’ll just live with whatever’s there. And for sure there’s a huge spectrum, right? So and on top of that, we don’t want to know when things are wrong. You know, if you usually it takes symptoms that begin to impair our functioning or our lives in such a way that that it necessitates seeking out. But, you know, if you can kind of bear it, you know, there’s a there’s a just a part of just a human part of us that doesn’t want to really deal with it until we have to.
David Livingston, LMFT: But, you know, so I think that part of this awareness is and kind of what we’re talking about is it’s it’s better. It’s, you know, that that really that mental health has to do with changing that whole narrative to this idea of like, okay, I’m going to have we’re going to get sick. We’re going to have ups and downs and conflicts and deficits throughout our lives and problems with ourselves and others at times. And so what’s the best way to manage it?
So, you know, the people I see who are the healthiest go to the doctors when they’re at the first sign of something and they get help with if they’re beginning to, it feels like a depression is lasting longer than they want or something else. They get help with it and it becomes the framework. And I think when I think of sort of this period of awareness that that should be kind of the hope. And I know there’s like we’re all talking about a lot of factors, including resources that can make that very difficult.
Clare Waismann, RAS/SUDCC: Yeah, but I think also, David, you know, even the ones with resources, how often do you hear our patients say when we ask them to, you know, do you have a psychiatrist? Well, we’re looking for one, but there is a six-week waiting period for them to see us. How many do we hear?
David Livingston, LMFT: All the time. Most of the time. In fact, I would say the greatest, one of the things that is that that’s that happens more often than not by far. And so what happens is, is people give up. Right. It becomes too difficult. They’ve figured out how to live with themselves and whatever they know.
Clare Waismann, RAS/SUDCC: They think they do.
David Livingston, LMFT: Right. Right. And so. That’s exactly right. And so one of the things that is that I try to do is just literally emphasize about as strongly as I can that you have to you’ve got to go in and get these things resolved. Otherwise, you remain vulnerable, you know. And sometimes it’s as simple as people, as a sleep disorder. I mean, not simple, but that’s not simple. But it’s you know, I mean, sleep regulates everything if you, you know, so it can be many things. But yes, I am so in agreement.
Clare Waismann, RAS/SUDCC: So again, you know, we are using the May Awareness Month, you know, to talk about it. You know, I think the United States as a country, you know, has so much resources that are being misdirected to the problems after they become problems instead of, you know, using our resources for education, prevention, you know, awareness. So we are always, you know, running behind the issue once the issue becomes, you know, project society. So and now we’re trying to fix the homeless issue, the addiction issue, but the crime issue. But all, you know, withstands from the lack of mental health care.
David Livingston, LMFT: So so one of the psychological dilemmas that impede and just this is an internal process that I see all the time. So the people so so the part of us. So the people need that that that need taking care of, you know, babies need taking care of their entirely dependent and they need taking care of. As we grow up, we become increasingly independent, hopefully. And so then there’s a part of us that does not want that feels like in some ways we’re being more like a baby when we need help.
So what you see and one of the reasons that people don’t seek help is it evokes a feeling of that helplessness and that dependency. But what you see in people who are of worked out that conflict, they understand that dependency and healthy dependency goes on forever. It never ends. In fact, the strongest people, the healthiest people have healthy dependencies. They have good doctors. They have friends and family and people around them who bring meaning to their lives. They, you know, they support each other. They talk about things. I mean, there’s all kinds of dependency.
It’s not necessarily correlated or even thought about in that regard, and yet it’s the case. So there’s a part of our society that has. You know, and I don’t think we’ve known how to talk about it from an internal place because we don’t like dependency. Right. Because it evokes this feeling of more the baby part of us, which we’re supposed to be out of. But it’s never true.
And the stronger we are, the healthier we are. The more things are getting resolved, the more potential for independence and strength. It goes back and forth. And this is one of the internal conflicts that I have to that I talk to people about all the time.
Dwight Hurst, LPC: What are some things that Waismann Method is doing in the group here to help with that promotion? To raise awareness?
Clare Waismann, RAS/SUDCC: We just put today a press release talking about it. We are daily putting all over social media, you know, facts about mental health. We are sharing resources for available mental health. We are discussing the need, you know, on Twitter and Facebook for additional mental health. So just truly, truly creating education and awareness that I truly believe is the best way of prevention. So we’re going to use this month like every day in the morning. You know, we take an hour to put as much information out there as we can.
Dwight Hurst, LPC: Yet. I know Marina is the one who who heads that up and she helps coordinate the recordings in the podcast here, too. She’s excellent with that stuff and I feel like Waismann Method really utilizes social media and announcements very well, which I mean is honestly, one of the things that that is useful about that is it’s a good example. I find a lot of people struggle to know how to promote and help know if it’s like, well, what can I do? You know? It kind of be an advocate for my loved one or for myself. And sometimes just sharing something and sharing information or an article or your own story or whatever it is you’re willing and able to share online. That makes a huge difference, I think.
Clare Waismann, RAS/SUDCC: Yeah. I think I think it makes you as a person, you know, feel good to feel part of the solution, you know, makes you feel productive some way. Somehow, even if it’s 10 minutes a day, you are in Quora, you are on Reddit, you are on Twitter. You know, just helping somebody and answer a question of somebody that is, you know, needing that help on that moment, that support. Mm hmm. They help. I would say support. I think it’s important.
Dwight Hurst, LPC: And speaking of the access to care, it’s interesting. As I’ve worked with people myself over the years, sometimes when someone is going through a time where they can’t access, they don’t have any money or even when they are accessing treatment, sometimes there are there are little communities out there, little pockets of communities out there that are able to exist online. There are Reddit subreddits where people share their story or talk about their own therapeutic experiences.
There’s a couple of groups out there that are I mean, people are mostly familiar with free resources, such as 12-step groups and support groups. But there’s also there are harm reduction support groups and cognitive therapy-based support groups that are also out there that are available to, you know, that you can find that are low cost to no cost sometimes.
Clare Waismann, RAS/SUDCC: Even NAMI if you go into NAMI’s website at nami.org quite a bit of resources over there that they partner with from people all over the country.
Dwight Hurst, LPC: You guys are partnering up with them, right?
Clare Waismann, RAS/SUDCC: We are, you know, we’re just joining anybody that, you know, is willing and ready to make a difference out there. So we’re always looking for, you know, people to create more awareness and education. NAMI has been heading through social media. The Mental Health Awareness Month, I think because we work with addiction as well. And I think they become talk about that is you can’t work with addiction and ignore mental health.
You know, it’s what we do is an incredibly important part of treatment for those struggling with addiction. But it’s just a part of it. You know, we are detoxing them so they are emotionally present to deal with whatever mental health issues they have. So it’s a combination of efforts. It’s something that we work with every day as well. And I think a lot of people that we work with wouldn’t be here if they got the resources and the help they need when they need it.
Dwight Hurst, LPC: What are some of your thoughts about that, David?
David Livingston, LMFT: Clare handles the outreach and that whole part of it, and I’m really more focused on the very specific and individual work. And so but they go together. And so, I mean, ultimately the idea is you’ve got to reach people and help them understand that there’s there are answers. And then you have to provide them with personal and real ways of understanding what’s what they’re what’s troubling them, that that moves, you know, moves their life in a direction that they’re needing.
And so, you know, it’s there’s two parts to it. And she handles that whole outside part of it. And so. But, you know, ultimately, you know, I think the idea that there’s an awareness, you know, I only talk I think well about it on a more interpersonal way. But they go together.
Dwight Hurst, LPC: Well, it’s interesting that a long time ago, we as a society decided that we couldn’t, you know, that we were going to treat. Addiction is separate from mental health, it seems like. And so it became the purview of law enforcement because of the behaviors that provoked. Right. And that created sort of a standard of like, well, there’s weird behaviors. So we have to have community protection. And then it also demonized. And I think, you know, we could talk about lots of contributing factors to that. But one of the main reasons was that we didn’t understand the brain and how it could work.
And so we just knew someone’s acting a certain way. They’re ingesting their, you know, fill-in-the-blank insult, drunk addict or whatever it is that we throw out as an accusation. And there’s still I think we still struggle with those labels and those things, especially with addiction, you know, mental health as well. We have it a lot of times where we say take someone with a developmental issue or someone on the autism spectrum. Sometimes our definition of health is they should act like everybody else instead of being like, no, they just need to be mentally healthy. And if they have some personality issues that are not mentally unhealthy, but they’re a little bit different the way they approach life. That’s okay, you know.
David Livingston, LMFT: Well, that’s right. Right. And so I think the whole framework that that addiction is a choice really clouded everything because it’s so much more complicated. It’s and I’ve used this analogy before. It’d be like holding on to a bar. Right. And eventually, at some point, you can say, well, you made a decision, you chose to let go. And that’s true. It’s at some level on on if you’re just looking at some point, there’s, you know,it’s true.
But addiction is more like the process of letting go where the tensions just develop at such a level that a decision happens. Right. So from the disease model and I think the disease model tried to remedy this in some ways, but I don’t think it’s perfect either because we do have to have agency in our life. We do need to know what to trust. And frankly, people do really know when they’re making good decisions or bad decisions. But if there’s too much tension and the brain is in you know, in haywire on dealing with a substance, you know, you’re not dealing with an even playing field.
So so like Clare’s saying, you have to get them off the substance, get the, you know, get some time in where the and then you can begin to sort of address the other tensions that lead to sort of unwanted behaviors.
Clare Waismann, RAS/SUDCC: I think, Dwight, what you were describing before, you know, is the old view of what somebody’s struggling over addiction. I think we have learned on the last ten years of the opioid crisis that’s not the case. Your aunt, it could be your kids. You know, you could be your brother, it could be your doctor. So it’s different. And it’s it’s a consequence. It’s a consequence of that exhaustion, of feeling, of a certain stress, like David was saying, you know, it gets to such a point of discomfort with yourself, that you start seeking something just to give you a break from that.
Do you know how many parents they know? When we speak about coming in for treatment and you know, we ask, is there was he ever diagnosed with mental health issues? No, no, no, no. There’s zero mental health issues. And then as you start talking, oh, he’s always been very difficult. No, he never socialized yet. No, no. Yeah. He’s easily angered and they just describe, you know, somebody that has not been able to live, you know, a quality life, period, you know, at least in my thought is. Because the parents will describe how difficult the child is, you know.
Now, the question is, have you ever stopped and thought, you know, how difficult it is for him to feel this way all the time? Have you ever thought why he’s feeling this way all the time? Why is he angry all the time? Why? You know what I’m saying? Is he causing issues all the time? But a lot of people just see it as, you know, they can get over it, they can change it, and they completely ignore the issue. And that’s how we end up here.
Dwight Hurst, LPC: Yeah, it’s interesting how you put it with the idea of early intervention or early identification. And sometimes we want to avoid bad news so badly that we don’t want to see it. You know, there’s also it’s another old-school mentality that touches on addiction, which is medications. Sometimes people are hesitant for medical intervention because they think, well, I don’t want my child or I don’t want myself to treat my mental health with drugs because drugs are bad. And the interesting thing is that a lot of research indicates that if you are properly medicated or treated and often therapy and medication go hand in hand, you’re a lot less likely to develop self-medication problems, which is interesting.
Clare Waismann, RAS/SUDCC: Correct. But I think that comes as well from, you know, so many people were so overmedicated for so long, especially kids that, you know, people feel a little weary. So, again, you know, I think medicine is as good as the ability and the honesty of the doctor that is treating you. You know what I’m saying?
Dwight Hurst, LPC: Yes, exactly. No, I think and it goes back to that experience, too – people having bad experiences. There’s been, you know, a lot of movement forward in the addiction field and in the mental health field, especially if you go to a professional, you know, person who’s trained and has the experiences that there’s a lot of forward momentum in treatment that’s changed. And I think there’s a generational expectation that ties in with what you said, if there might have been, you know, a lot of bad experiences, I know a lot of people that were pushed into group homes and things that weren’t very good when they were youth.
And they’re that individual is, number one, maybe more likely to have the children have some genetic vulnerabilities to depression or anxiety because mood disorders, you know, traits can be inherited that way and less likely to go get help because they’ve been betrayed and treated badly and had bad experiences so that that can compound itself.
David Livingston, LMFT: Almost inevitable if you’ve had bad. I mean, it’s hard enough to go. It’s hard enough to kind of come to terms with things that aren’t working. And anyways that if you’ve had bad experiences, the desire to avoid becomes can people can never sometimes get the treatment they need. And like you’re saying, if you get effective treatment and help, your life should get better. In fact, that’s kind of the litmus test. And one of the things I say to the patients I’m working with is, “Build a relationship and make sure you have confidence.”
And one of the reasons why one of the core elements of therapy is listening is because the other person knows what’s going on and is supposed to you know, you’re supposed to listen. And so because the other person knows himself ten times better than you, you do or you will. So, you know, that’s that’s all. So you’ve got to learn.
Dwight Hurst, LPC: And we’re going to call it there for today. Thank you so much for listening, and this month, as in all months, we would encourage everyone to seek out mental health treatment, seek out addiction treatment from certified and trained professionals who can help you to plan out your recovery. We’d love to hear from you at [email protected] Or go to www.opiates.com. Our website. We are also on Twitter @opiates.
I’d love to hear if you want to know more about Waismann Method, but if you just have general questions about opioid dependence and things that you just have questions that you’d like us to address on the show, we’d love to hear from you and we love to talk about those things. Our music is the song Medical by Clean Mind Sounds for David Livingston and Clare Waismann. I’m Dwight Hurst.
Remember to keep asking questions because if you ask questions, you can find answers. And if you find answers, you can find hope. Thanks for being here with us on the podcast. We’ll be together again soon.