Why Holding Space is Important

Oct 17

Dr. Erica Montgomery, clinic director of the Counselor Education Clinic for Outreach and Personal Enrichment (COPE), joined co-hosts Meagen Rosenthal, Ph.D, and Alexis Lee for The Mayo Lab’s eighth episode of Season 2. Dr. Montgomery discussed the impact of stigma on mental health, depression and the importance of sharing evidence-based information.

Stigma surrounding depression and mental health is a significant barrier to treatment. Dr. Montgomery explained how people often feel shame and judgement when seeking help, leading to resistance in reaching out for support.

“Honestly, stigma is one of the biggest barriers to treatment that I’ve come up against with my clients because there’s so much shame around mental health challenges,” she said.

For families with a child who’s dealing with depression, it can be difficult to reframe the way parents think about mental health issues. Together, Dr. Montomery, Alexis and Dr. Rosenthal discussed the importance of being non-judgemental and having listening skills when supporting someone with depression.

For communities in the South especially, stigma can play a strong role in perpetuating and reinforcing mental health-related shame. “There’s always this ‘We’re going to keep that quiet’ mentality,” Dr. Montgomery said.

Dr. Montgomery listed misinformation as one of the most damaging factors contributing to mental health today, adding, “Really, my advice for that would be, do your own research, talk to a doctor, talk to a counselor. Don’t believe everything you hear on social media, because they’re probably putting it out there for clicks and likes.”

“One of the things that comes up with parents a lot of the times in family therapy is that the parents feel responsible if their child is depressed, like, ‘I did something wrong’ … They make it mean something about whether or not they did a good job as a parent. And that’s really not the case. You can be the best parent that there ever has been, and you can be loving and supportive, and your child can still struggle.”

— Dr. Erica Montgomery

In a conversation about community mental health, Dr. Montgomery shared a quote she read recently: “We’re all in the same storm. We’re not all in the same boat.”

“While we do have the same experiences,” she said, “we may not all have the same access to resources to deal with those experiences. So I think that that’s an important factor as well, just being sure that those resources are accessible no matter where you are in life, but it is the same storm. We are going through it together. So it’s important to know you’re not alone.”

To hear more from Episode 8 of Season 2, scroll down to listen to the episode or read the transcript.

Watch the podcast on YouTube:

Dr. Meagen Rosenthal:
I am Meagen Rosenthal.
Alexis Lee:
And I’m Alexis Lee. And this is, The Mayo Lab Podcast. Hello everyone, and welcome back to season two of, The Mayo Lab podcast. I’m Alexis Lee, and as always joined with Meagen Rosenthal.
Dr. Meagen Rosenthal:
Hi, everybody.
Alexis Lee:
And we are so excited to have Dr. Erica Montgomery in the studio today, a UM professor and family member of this community. So we’re so excited. Welcome.
Dr. Erica Montgomery:
Good morning. Thank you for having me.
Alexis Lee:
I’m excited to dive into the topic of depression and stigma around depression today. But before we get there, Dr. Montgomery, will you tell us a little bit about yourself, your background, and how you got to UM.
Dr. Erica Montgomery:
Absolutely. I was saying before we got started, this is probably the hardest question that I had to contemplate for this meeting. So I’m a mom, that’s one of my favorite roles personally. I have an eight-year-old son, married to my best friend, and I like to read and write, and I really like to meditate. So that’s me in a nutshell, personally. Professionally, I’ve been a counselor since 2011 and I started working with families and their children doing play therapy, working in different capacities. And then a few years into my career, I went into hypnotherapy because I started doing my own deep healing work. So that really interested me as a way to heal on a deeper level with my clients. And so got some training in that, got some training in trauma-focused CBT, and started working with adults, children and families with trauma.
So I’ve kind of been a little bit of everywhere. And most recently I completed my PhD in counselor education. I finished that in November of ’22. And my dissertation work was actually using mindfulness-based stress reduction to reduce aggression in adolescent girls. So that was probably the highlight of my PhD was getting to work with that community, getting to work with those girls. We did the intervention groups in Plantersville, Mississippi. I don’t know if y’all know where that is. It’s a little south of Tupelo. They were wonderful and their faculty and staff really, they were committed to improving the mental health of their kids. And so that was a really important involvement for me. So very thankful that I got the opportunity to do that with them. But currently I am working for the University of Mississippi, like you mentioned.
I am clinic director of our COPE Clinic. COPE is the Clinic for Outreach and Personal Enrichment, and it’s the Counselor Education Training clinic where all of our interns come to do their practicum and internship work. So we offer free in-person and telehealth mental health services to anybody across the state. So another important resource for us just to be able to give back. And I also do youth mental health first aid training. So that’s something that we had talked about earlier. That’s one of my favorite projects that I have right now is just being able to teach people how to work with youth who are having mental health challenges.
Dr. Meagen Rosenthal:
That is incredible, and I’m so excited to dive into the breadth of things that you’ve been involved with in your career so far. I think that’s very cool. And also side note, congratulations on finishing your PhD.
Dr. Erica Montgomery:
Thank you.
Dr. Meagen Rosenthal:
That’s a huge deal as somebody who’s done it and then somebody who’s about to do it very shortly, that’s a huge accomplishment.
Dr. Erica Montgomery:
Thank you.
Dr. Meagen Rosenthal:
And what an amazing project to be working with a group of young women and getting them to a better place and figuring out what it looks like so that we can ultimately scale that knowledge and expertise across a broader group of human beings on the planet. I think that’s one of the most fun pieces of doing research is like you’re answering questions, but then you’re also figuring out, “Okay, how do we help everyone else who I might not be able to have hands on in the beginning get benefit from this new knowledge?”
So thinking through the topic of discussion today and what Alexis mentioned at the beginning of, we’re talking about depression and what that is and how that manifests itself in our families and our friends and in our peer groups and all of that. But because we’re thinking through this on kind of an educational level today, can you just give us a little bit of a definition from a clinical perspective, what depression is? And then maybe we can go into how it might manifest itself in different groups of people.
Dr. Erica Montgomery:
Sure. Yeah. So I think the misconception about depression is that it’s just sadness, but it’s so much more than sadness. It’s this pervasive, persistent low mood that really impacts every area of a person’s life. So ways that can show up may be low energy, may be sleep disturbances, really losing interest and things that you used to enjoy, just that lack of enjoyment of life, that lack of zest that somebody maybe once had. So it’s just a lot more than I think we conceptualize. It can even impact appetite and concentration. So if a person in your life, or if you’re experiencing depressed mood or depression in a clinical sense, it can really affect all the areas of your life at once, which makes it that much more difficult to get a handle on.
Dr. Meagen Rosenthal:
Is there any, because I think what you’re saying about depression being a lot of different things, not just being in a bad mood or feeling sad, is there any differences in how it shows up in young people versus adults or young children? Because unfortunately, we have a growing population of young children who are experiencing depression, our adolescent population and adults. Is there differences in terms of what you’d look for across those groups?
Dr. Erica Montgomery:
There can be, yes. Because oftentimes in children, it shows up as acting out. They just don’t have the verbal capacity to be able to tell us that I feel sad and I don’t know why, or I felt hopeless for several days in a row. They don’t have that language. So there’s maybe more behavioral, and then adolescence is always a time that’s kind of unstable in our development. I think that’s the word I’ll use, unstable, because everything is just in flux. Everything’s changing for us at that time.
So it could look like withdrawal from their friends, or if they once loved a sport, then they decide to quit the team. So it can look like withdrawal from things than people that they loved at one time. And then in adults, we have a different level of responsibility in our lives. We have things like, “I need to go to work, I need to pay the bills. I have family.” So ours may be more subtle, but it can still show up in things like depression, lack of concentration. Depression, I mean low mood, lack of sleep, lack of appetite. There are just more subtle ways that it may show up in adults.
Alexis Lee:
How do you differentiate between maybe a few days of just being something’s happened.
Dr. Erica Montgomery:
Sad?
Alexis Lee:
Yeah. And you’re sad, or maybe you are trying to get over, maybe it’s been a bad meal, and you just don’t realize that it’s maybe not the flu or food poisoning, but you just don’t. What is the line or how do you walk that to say, maybe I’m just having a bad week or a bad day versus maybe it’s a month, I guess? Maybe I’m answering my own question.
Dr. Erica Montgomery:
Well, I definitely think that the frequency and the duration of the symptoms tells us a lot about what’s going on, but depression is much more than just environmental or situational. There’s biological and psychological factors as well. So it could be a low mood that you can’t shake for a long time. Like you said, it could be something that’s brought on by the loss of a loved one and grief, and depression with grief. So it can come on and stay on for different amounts of time.
Dr. Meagen Rosenthal:
I think that one of the other things that kind of strikes me around this topic and in our overall theme for the season two of the podcast this time around, related to stigma. And I wondered if we could get your thoughts on stigma related to depression in particular, but mental health in general as you have viewed it as a clinician and provider in that space.
Dr. Erica Montgomery:
Honestly, stigma is one of the biggest barriers to treatment that I’ve come up against with my clients because there’s so much shame around mental health challenges. There’s not only the mental health challenge you’re dealing with, but when you go to someone in your community and they tell you, “Well, you just need to pray about it harder,” or, “Why don’t you cheer up?” Or, “Try thinking about something else.” There’s this internalized shame that maybe I’ve done something wrong to cause this, or maybe there’s something wrong with me. And so when we have that stigma of it’s a character defect to be depressed or to be anxious, or whatever mental health challenge you’re going through, then it becomes this shameful experience and really that keeps people from reaching out for help.
Dr. Meagen Rosenthal:
And what are some of the ways in which you work through? I mean, what we’ve learned so far this season that stigma affects different levels and different kinds of ways from the individual, to the family, to the community. But when you’re working with that individual who has finally found some way to get the courage up to come and ask for help, and how do you work through that internalized shame that they might have, that they have done something wrong, or that they have a character defect as you said, to get them to a place where they can be accepting of the help that you could be providing to them?
Dr. Erica Montgomery:
Well, that’s a great question. I think just the act of reaching out, of realizing that this is something bigger than I can handle is already a step towards healing that shame. And being that person that can sit there non judgmentally with them and just sit in that space and hold that space for them really goes a long way to healing that. There’s so much judgment outside of that relationship in therapy that we get the privilege of holding that time with them so that they have that place where they don’t have to face that judgment.
Dr. Meagen Rosenthal:
Because we hear a lot about this in the wellness community and the self-help space, holding space, being non-judgmental. What does that mean in practice? We get into the weeds on this podcast. So what does that actually look like in practice? Right? Because it’s one thing, I’m not judgemental. Okay, what does that mean?
Dr. Erica Montgomery:
Right. So first off, as counselors, we have to be aware of what our values are, of what that looks like. When we go into a space with somebody, what do I think about depression? What do I think about positive psychology and self-help, and the tools that are available out there? Getting really self-aware with what it means for you to deal with that topic so that you ethically can show up with that person. And if you have those judgements come up, because we’re just humans. A counselor is just as human as the next person. So we’re going to have thoughts and feelings about the things that come into our space, but we have to learn to set that aside and to say, “This is not about me. This time is not for me. This is for the person across from me.” So just I think the first step is being self-aware of what actually comes up for me during this time with this person.
Dr. Meagen Rosenthal:
Interesting. Interesting. I think that’s a really good point, and something I think that other folks can be thinking about. What are your values? What does that look like? But you mentioned a term or a phrase or a field of research. I want to just pause on for a second. What is positive psychology? Can you give us a little overview of that? So for those of the folks who are listening who might not know that term.
Dr. Erica Montgomery:
Sure. So positive psychology really has kind of come into its own in the mainstream media with social media, with people on TikTok, YouTube, wherever you make your videos, talking about just ways to help yourself to stay positive, to reframe thoughts in a positive way. Gratitude plays a big role in positive psychology, and that’s not my area of expertise by any means. So my very shallow understanding of it, it’s just that reframe of how we’re looking at things through a more positive lens.
Dr. Meagen Rosenthal:
Very cool.
Dr. Erica Montgomery:
That’s what I got.
Dr. Meagen Rosenthal:
No, that’s great. That’s great.
Alexis Lee:
I mean, yeah. That’s how I would’ve described it. And I’m not an expert in your field either. So that one…
Dr. Erica Montgomery:
I did all right.
Alexis Lee:
Shifting a little to, as a counselor and then the individual, having those one-on-ones to being maybe a family member or a friend, maybe the person who’s suffering with depression can’t afford or doesn’t have access to counseling and those resources. When they come to friends or family, what’s a way that they can, other than what you’ve named, set aside that judgment in a way and just be available for them, but also not step in and try and act as a counselor?
Dr. Erica Montgomery:
Sure. I think that’s an important piece is that we don’t try to, well, counselors don’t give advice, but even if someone that you love comes to you or your friend comes to you and says, “Hey, I’m really depressed. I’m not able to do things like I used to,” and they’re really struggling, you see that, try not to give advice. That would be the first thing is just listen and just be there. It can be difficult to watch someone that we love go through something hard that we can’t fix for them. So our natural inclination is to jump in and try to solve and rescue and fix the problem. But what’s most helpful is just to exist with them. So if that means just go into their house and sitting with them on the couch while they lay there and watch TV, that’s what we do just to be in that same space and love them in that way.
Dr. Meagen Rosenthal:
And if we’re talking through, so we’ve broadened out from that individual, one-on-one interaction with a counselor to how can families exist and be with that person in the moment that they might not be in a good place. But let’s bring this back to the stigma piece of this. So in your work, because you’ve worked with individuals and you’ve worked with families as well, what are the kinds of stigmas that you witness in your interactions with families as it relates to depression or mental health issues or any of those kinds of things?
Dr. Erica Montgomery:
One of the things that comes up with parents a lot of the times in family therapy is that the parents feel responsible if their child is depressed, like, “I did something wrong.” And so there can be this sense of shame within the family system as well of the parents taking responsibility for how the child is feeling and saying, “Well, in my family, we don’t feel this way. We don’t get depressed in this family.” And really taking ownership of that, that doesn’t belong to them. They make it mean something about them and their parenting, they make it mean something about whether or not they did a good job as a parent. And that’s really not the case. You can be the best parent that there ever has been, and you can be loving and supportive and your child can still struggle.
Dr. Meagen Rosenthal:
I think that is a really brilliant observation because in the time that Alexis and I have been in this space and talking with families and parents around these kinds of issues, that internalization that parents bring to the table. Because nobody has a child with the intention of being that, that kid is going to have struggles. That’s not what we do. And I believe that comes from a sincere place of just wanting the best for them. And so if you were to, and in your conversations with parents who are working through that and your maybe mental, how I would think about it is, it’s not about you, it’s about them. But how do you get parents to that without skipping over the fact that those feelings are real, and that come from a good place too. So you have a really complicated job, but how do you do that?
Dr. Erica Montgomery:
I do think it’s a dance, but recognizing that that’s where that parent is coming from, that they want the best for their child, and really validating that feeling of, this was not what you wanted for your kid. And there’s this powerlessness that I can’t fix this, that I can’t make it okay. And so just validating those feelings, recognizing where it comes from for them, and that it’s really difficult to watch your child struggle. I think that’s the first step, and being able to reconcile some of that. It’s just recognizing it.
Dr. Meagen Rosenthal:
And when you mentioned the idea or the program that you’re involved in with Mental Health First Aid training for youth, can you walk us through a little bit about what that is? And why it’s something that you have obviously a good deal of passion for and interest in the breadth of work that you’re engaged in?
Dr. Erica Montgomery:
Sure. I really do love Youth Mental Health First Aid. It’s one of my favorite things that I get to do. I always say that my job doesn’t feel like work. So this is one of the things that I have the most fun with, is being able to teach people how to help kids who are dealing with mental health challenges. So far, we have worked with school districts, we’ve worked with secondary education students, with UMC down in Jackson. I’ve worked with different teachers, administrators, coaches to offer this training just to give the adults in these children’s lives some tools.
Some resources of when you see this, when see these behavior changes and you notice they’re not eating lunch with their friends, or you notice that they cry after class, what can you do to intervene? How can you get them connected to resources? So what we talk about is a five step action plan that just gives them the tools that they need to step by step, assess what’s going on, and be able to give those encouraging resources, information and be able to be a good listener, because we’re not taught listening skills really. So I think it’s important to have those listening skills in your back pocket to be able to be there and ask those open-ended questions just to support and not to give advice.
Dr. Meagen Rosenthal:
Absolutely. And because we’re in the weeds again, can you walk us through what those five steps look like without giving the farm away? Right. Because if you have access to Mental Health First Aid training for youth, you should absolutely go and take advantage of it. But let’s do a little teaser so we can get folks interested and signed up.
Dr. Erica Montgomery:
Sure. And for people who are interested in it, we have a grant right now, so we’re doing it for free through counselor education.
Dr. Meagen Rosenthal:
Fantastic.
Dr. Erica Montgomery:
If that’s something that you’re interested in or any listeners are interested in, then there are resources available to get it for free. So like I said, there’s a five step action plan that’s all revolving around assessment. And each step you want to assess and be sure that there’s no risk of harm to the child or the people around you, that it’s not a crisis situation where we’re not looking at something like an overdose or suicidal ideation. So we want to constantly assess for that crisis and that risk. And then just learning how to approach the child, what do I say even? Because you’re working with, like we said teenagers earlier, there’s a lot of instability for their relationships and their self-concept. So we want to learn those skills of how do I even begin to approach this person? How do I start a conversation? And then from there, just learning those listening skills and what resources are available and how do I get them connected to that? So in a nutshell, that’s-
Dr. Meagen Rosenthal:
Yeah, no, that’s perfect. No, thank you.
Voiceover:
You are listening to, The Mayo Lab podcast. For more information and resources, visit themayolab.com. Now, back to the episode.
Dr. Meagen Rosenthal:
No, and I think I want to circle back to what you said too about listening skills, right? I think that my dad used to say this to me all the time. There’s a difference between listening to wait for your turn to talk and listening to listen to what the person is saying. And so from your perspective and your area of expertise, what are listening skills and how do we practice those?
Dr. Erica Montgomery:
Well, your dad was absolutely right for one. Good job, dad, because there’s a difference in listening to respond and listening to understand. So when we’re sitting with someone and we really want to hear what they’re saying, we want to listen to understand where they’re coming from. Part of that includes putting those judgments down, putting down that what I think about this, and really hearing where they’re coming from and what their experience is. I want to listen to you to understand you and to understand your worldview. And I lost the question.
Dr. Meagen Rosenthal:
Listening skills. Listening skills.
Dr. Erica Montgomery:
Listening skills, okay. Maybe need to beef up my talking skills. So listening to understand is one, good eye contact. Be sure I’m attending. Be sure I’m with you. Don’t have your phone out. If somebody’s talking to you and you’re on your phone, that really leads them to believe that you’re not engaged, that you don’t care, and you could just be holding your phone. You don’t even have to be on it. So people are much more likely to approach you and to tell you about their experience in a candid way, if you are really attending with your body. So attending with your body, attending with your face, your eyes, your ears have everything turned on and tuned on.
Dr. Meagen Rosenthal:
I love this idea of thinking through the distraction piece. How often do you walk without your phone somewhere or do that? That’s such a normal part of our existence now.
Dr. Erica Montgomery:
It’s an extension of my hand.
Dr. Meagen Rosenthal:
Right, right, right. And there was something I read last week was talking about how there’s this new syndrome, I’m putting that in air quotes for those of you who are listening, that’s talking about the panic people feel when they don’t have their phone physically next to them, and that not being connected for a time. But I think your points are totally valid and completely well taken to think through how do you attend not just with your ears, but with your whole existence and thinking about putting those items down and engaging in that. And when I work with students on, I’m a qualitative interviewer by training. So part of that is to get people to tell you their secrets. That’s the job of qualitative interviews. And so it’s thinking through not being distracted, attending with your body, as you’re saying, putting those things away. If you think about it from the other side of the table, do you feel listened to when the person who’s supposed to be listening to you is holding their phone or scratching notes or not?
Alexis Lee:
They’re not looking at you.
Dr. Meagen Rosenthal:
Looking at you. Right. Yeah. That’s a completely normal thing when you flip it around to be like, “Well, no, of course they’re not listening.” But it’s a really hard thing to remember to do when you were the person-
Alexis Lee:
You’re the listener.
Dr. Meagen Rosenthal:
… Who’s supposed to be listening, right?
Alexis Lee:
It’s like that golden rule, treat others how you want to be treated.
Dr. Meagen Rosenthal:
Yes.
Alexis Lee:
In all facets.
Dr. Meagen Rosenthal:
It is. It is. No, it’s so funny how those fundamentals keep coming back like that golden rule or there’s a reason it’s been around for so long. No, that’s awesome. I love that. So I’d like to switch gears. So we talked about individuals. We’ve talked about family units and friend units, and people within your inner circle. Let’s talk about communities now. What does depression related stigma or mental health related stigma, what impact do you see that that has on our communities on a larger scale?
Dr. Erica Montgomery:
Sure. Well, for one, I think that the stigma, the shame around mental health challenges is really perpetuated and reinforced in our communities, particularly in the south. I’m not sure if it’s a southern thing or if that’s just my perspective because where I am, but I noticed that there’s always this, we’re going to keep that quiet mentality. And so the more that our communities can learn about what these symptoms really look like and the range and severity of these symptoms and how we can help, I think we’re going to see more healing in our communities on a larger scale, in a bigger sense.
Alexis Lee:
And circling back a little bit to depression, this idea, depression, I’m assuming, but does depression exist in a silo or is it a side effect of other maybe mental illnesses or struggles? Or can other mental illnesses and struggles be a side effect of depression?
Dr. Erica Montgomery:
All of the above, yes. So depression, it can be standalone. You may not have any other co-occurring disorders with it, or it could be part of another set of issues. Certainly it can be part of other issues like bipolar disorder, because there’s the ups and downs, the highs and lows with that. But it also is seen pretty frequently with anxiety as a co-occurring disorder. I think that that’s a real struggle, a real challenge to balance both of those things. I’ve seen that a lot with my clients is that they feel anxious, but they’re too depressed to do anything about it. Or they feel depressed, but they’re scared to reach out for help because they have both of these things happening at the same time. And so yes, depression can be by itself, but often we see it with other things, particularly when there’s been a major life change, adjustment issues, like I said earlier, grief. There are environmental factors that can contribute to that as well. It can definitely be with other issues.
Alexis Lee:
How long, in a way, and I’ll phrase this, my counselor at one point had me do a scheduling thing. It was like, “Look back in your calendar six weeks ago and kind of see what happened, has happened, and then what is causing some of the issues and struggles I’m having now.” Is there a timeframe that maybe if a environmental changes happened? A move? A grief that maybe the pent-up energy can take longer to show than rather than be right away?
Dr. Erica Montgomery:
Well, sure. With adjustment disorders, what you’re usually looking for is something that is acute, so six months or less. And then something more chronic would be a different diagnosis. It might be something like major depressive disorder. So if we’re looking back six weeks, then that can absolutely be an adjustment. So I think it’s important too. You bring up an important part of this is knowing what happened just before the change occurred in your mood. Looking at what are some of those environmental factors that are happening for me around the time that I noticed that I stopped wanting to go out with my friends, or that I stopped wanting to get up and go to work or wear necklaces.
Alexis Lee:
Yes.
Dr. Meagen Rosenthal:
I just started wearing necklaces again, post pandemic, realized I was not-
Alexis Lee:
Yeah. The pandemic conversation-
Dr. Meagen Rosenthal:
… Taking advantage of all of my fabulous clothes. Shocking.
Alexis Lee:
The pandemic conversation will probably be, it’s a whole other season.
Dr. Meagen Rosenthal:
Oh my gosh. Yeah. Yeah. Absolutely.
Dr. Erica Montgomery:
I actually just read this morning, I wrote it down an article from Berkeley that well reported depression rates since COVID have tripled in the US.
Dr. Meagen Rosenthal:
Wow.
Alexis Lee:
Wow.
Dr. Erica Montgomery:
Yeah, I was really floored by that. And I mean, that’s what’s reported, and we know that so much goes unreported because of things like stigma. And people are just afraid to reach out for help. Earlier I mentioned that adults, they have all these responsibilities, and so it may look different, more subtle, but that could also be because people are afraid they’re going to lose their jobs, they’re going to lose their kids because we still do have this thought that it’s a character defect to be depressed. So yeah, COVID, that’s a whole conversation.
Dr. Meagen Rosenthal:
That is a whole conversation. But I think your statistic there saying that the rates of reported depression have tripled since the pandemic, is such an important observation. Because I think that we have this weird balance when we’re talking about mental health issues, things like depression, anxiety, et cetera, because we have this idea that the stigma has prevented some people from getting the care that they need. But we’re also seeing that this skyrocketing a number of reported cases and number of instances. So on one side, it kind of gives me a little bit of hope, because at least maybe those cases already existed and folks are getting help now.
Dr. Erica Montgomery:
And we didn’t know. Yeah.
Dr. Meagen Rosenthal:
And we didn’t know. So there’s a shift in the conversation that’s taken place since the pandemic that minimally, maybe, we can go and seek out some assistance.
Dr. Erica Montgomery:
And we’ve made it so much more accessible now with telehealth, telehealth has become much more accessible. That’s the word. And so even at the clinic at COPE, we implemented telehealth as a response to COVID. And we continued it to this day. And it has been just a tremendous tool in being able to help people across the state who may not be able to get to a counselor. Like you said, they may not have the resources, the money, the transportation. And so just being able to meet them where they are, to tell them that, “You don’t have to come to my office on my turf. I can meet you on your couch.” It’s been so helpful in getting people the help that they need in various settings. So it’s been great.
Dr. Meagen Rosenthal:
Yeah. And I think that coming back to this conversation around what you mentioned earlier about how we think about and talk about mental health in the South being potentially a barrier to seeking out treatment. And I think one of the things that I have noted in the time that I’ve been in this space is that despite what we maybe say publicly, everyone, everyone, whether it’s you, your close family, your friend, somebody else in your community, we all know somebody who’s suffering with this. Know somebody who is suffering with substance use disorder or a mental health concern or some combination thereof. What are some, from your perspective in the work that you’ve done in this space, things that we can think about doing to throw back the veil on that? Because we know it’s there. We’re just not talking about it. So how do we start talking about it in a way that demystifies it and destigmatizes it?
Dr. Erica Montgomery:
Right. I think, well, just talking about it in general, it’s not something we sweep under the rug. It’s something people still whisper. “She goes to therapy.” So we don’t need to whisper about our counselors. And I’ve noticed that this younger generation coming up, they will shout it from the rooftops, “I go to therapy on Tuesdays at two o’clock,” and they are proud of it. And so I think that our younger people are really leading the cause on that, of just being vocal about it, talking about it, saying, “There are resources available, if you are suffering. You don’t have to struggle alone.”
But as far as how to talk about it, that is a really good question. I think that’s something that we’re all trying to figure out together right now, is how do we openly talk about these issues, letting people know that it is okay to be in that place. And we’re seeing a lot more of that now. It’s okay to not be okay. It’s okay to ask for help. Those types of sentiments. So we’re seeing more of that, just being open about what’s going on and accepting that people are going to struggle. And one of the things that I think we come across as a society is that we’re not comfortable being uncomfortable. So getting more comfortable with that discomfort, it would be a huge step in the right direction.
Dr. Meagen Rosenthal:
Yeah. I actually really love that, right? Because I mean, it’s part of the human condition. If we are all human beings and we are-
Dr. Erica Montgomery:
I hope we are.
Dr. Meagen Rosenthal:
… And we’re going through this life and we’re going through these things, and things are going to go bad sometimes and things are going to go well sometimes, and when they go bad, you’re going to have bad feelings about it. And sometimes those get out of control, and they’re not through any fault of your own. It could be other chemistry, physiological, whatever else is going on, but that’s normal.
Dr. Erica Montgomery:
It is.
Dr. Meagen Rosenthal:
It’s totally normal-
Dr. Erica Montgomery:
It’s so normal.
Dr. Meagen Rosenthal:
… To be in a funk. It’s totally normal to be angry. It’s totally normal to have all of those different kinds of feelings that we try to put in a box and ignore.
Dr. Erica Montgomery:
Right. It would be abnormal to be perfectly fine after your dog dies. That would be abnormal. It was a normal response to an abnormal condition. An abnormal situation.
Dr. Meagen Rosenthal:
Yeah, yeah.
Dr. Erica Montgomery:
Definitely.
Alexis Lee:
I listened to a podcast yesterday and they were saying one of the things that she loves to tell people is, “You are not alone. You are not the first person to ever think this thought. And you won’t be the last.”
Dr. Meagen Rosenthal:
Won’t be the last.
Alexis Lee:
And, “You aren’t the first or you won’t be the last to feel the way you felt.” And for some reason, us as humans, we really want to be special and unique. We all do.
Dr. Erica Montgomery:
It’s true.
Alexis Lee:
But the reality is we’re not. Everyone’s feeling this. Everyone is struggling in some way. Maybe it manifests differently, looks different, is caused by different things. But I mean, I have a reality that someone else in my friend group or family is struggling right now. The same things I’m struggling in. That’s just the reality.
Dr. Erica Montgomery:
I read something recently, and I can’t remember where. It was probably on social media somewhere, but, “We’re all in the same storm. We’re not all in the same boat.” And so while we do have the same experiences, we may not all have the same access to resources to deal with those experiences. So I think that that’s an important factor as well, is just being sure that those resources are accessible no matter where you are in life, but it is the same storm. We are going through it together. So it’s important to know you’re not alone.
Dr. Meagen Rosenthal:
I think I love that idea of making sure those resources are accessible to everyone.
Dr. Erica Montgomery:
Everybody.
Dr. Meagen Rosenthal:
Because that is the goal is to make sure that everybody can get to a better place and to whatever wellness looks like, happiness, health, whatever it looks like for them.
Dr. Erica Montgomery:
For them.
Dr. Meagen Rosenthal:
Yeah. I think that, well, I’m going to say it like this. Is there something you thought we would talk about today, but we have yet to talk about today, because I see you have notes, so I want to make sure-
Dr. Erica Montgomery:
I do have notes.
Dr. Meagen Rosenthal:
… To honor the fact that you did the note writing in anticipation of this conversation today.
Dr. Erica Montgomery:
One of the things that we didn’t talk about that I think is interesting is what are we doing to make it worse?
Dr. Meagen Rosenthal:
Yes.
Dr. Erica Montgomery:
So one of my notes on that is misinformation, especially on social media.
Dr. Meagen Rosenthal:
Very good. Very good. That’s a [inaudible 00:34:21].
Alexis Lee:
That’s a whole podcast by itself.
Dr. Erica Montgomery:
I will say this, and I’m really sorry. My parents are here this weekend, and my mom said something about, “Oh, I read something about this as being true.” And I said, “Where’d you hear that?” She said, “Oh, it was on social media.” And I said, “Yeah, we’ll come back to that later.”
Alexis Lee:
I’m just going to circle back to that.
Dr. Erica Montgomery:
But I think that’s one of the most damaging things that we can do is put it out there saying, “This food is going to cure your depression, or this breathing exercise is going to cure your anxiety.” Really, my advice for that would be, do your own research, talk to a doctor, talk to a counselor. Don’t believe everything you hear on social media because they’re probably putting it out there for clicks and likes. And so it’s not always, sometimes it is, sometimes it is, but it’s not always sound advice for what you’re going through. And it’s not specific to you because the way that it looks for me, may look different from the way it looks [inaudible 00:35:12] for you.
Dr. Meagen Rosenthal:
Absolutely.
Dr. Erica Montgomery:
Just being sure to be aware of that.
Dr. Meagen Rosenthal:
I think your comment about it being for likes or clicks or increasingly in a lot of different spaces for money. They’re selling whatever thing it is that they’ve got on-
Alexis Lee:
Their program they developed.
Dr. Meagen Rosenthal:
Right. And so being cognizant of that, and maybe the program would really work for you, but not diving in headlong before you do a little of your own due diligence.
Dr. Erica Montgomery:
Yes.
Dr. Meagen Rosenthal:
Additional research, talking to experts in this space, availing yourself of the variety of different resources are available for free online. There’s lots of really amazing resources that are available, and we’ll link some of those below the episode for this week. So you all can have those saved in your bookmark space for anybody who still does that. But I think that’s really important thing to recognize. Some things will work for some folks, some things will not work for some folks, but if you’re lining somebody else’s pockets to your own detriment, I mean, that’s not helping anybody, right?
Dr. Erica Montgomery:
You want to be sure that it’s going to be healthy for you.
Dr. Meagen Rosenthal:
Yeah, absolutely.
Dr. Erica Montgomery:
Not to say you can’t use those resources. If you find a meditation on YouTube and it works for you, good.
Dr. Meagen Rosenthal:
Awesome.
Dr. Erica Montgomery:
Do it. But be sure that you’re vetting your sources.
Dr. Meagen Rosenthal:
Yeah. No, absolutely. Absolutely. And that is, I love that because that is one of the goals of the podcast, is to make sure that we’re getting out those resources to folks that have been vetted, that have been recognized as being based in data, based in evidence, all of those different kinds of things. Well, I love that, and thank you for bringing us back to what could be making it worse, because I think that’s also a really important conversation to have. I think right now, and for those of you who have been listening so far this season, you already remember this. So the thing we like to close with are what is the challenge we’re going to leave our listeners with this week? What are some things that they can do for themselves, for their families, and for our communities to be working to building out a better, healthier existence for all of us?
Dr. Erica Montgomery:
Sure. So one of the things I like to do with my clients is ask them these open-ended questions that really get them to dig into what their values are. What are your beliefs? So my challenge would be to think about what do you think about depression? What are your ideas and your values around that? And what are the messages you’ve gotten from your family and your community at large about what that might mean? So how do you push back against that? How do you challenge what you’ve been taught and what’s been ingrained in you about depression?
Dr. Meagen Rosenthal:
Awesome. Awesome. I love that. I love that, because I think we take so much of that thinking for granted because we’re in that existence and we are in our communities, and we’re in our families all the time. So it’s hard to take that step back and really have a bird’s eye view of what that ends up looking like.
Dr. Erica Montgomery:
Think about what you’re thinking about.
Alexis Lee:
What about for families?
Dr. Erica Montgomery:
For families, be patient. That would be, I think the biggest thing. The first step is be patient. If you have someone in your family that’s struggling, we know that you want it to get better. We know that it comes from a place of love, but be patient with them and be present with them.
Alexis Lee:
And communities.
Dr. Erica Montgomery:
And communities. Let’s start talking about it. Let’s have these big, hard conversations and make those resources available. And if you know that there’s a community event that’s happening, let’s get out there, be a part of it, and just show up for each other.
Dr. Meagen Rosenthal:
Awesome. All sound pieces of advice and things that everyone can do now. So get cracking and let us know how it goes in our comments and our social media feeds. Thank you, Dr. Montgomery-
Dr. Erica Montgomery:
Thank you.
Dr. Meagen Rosenthal:
… For making the time to be here with us today. We appreciate your time and your expertise, and what a lovely conversation that we’ve had this morning.
Dr. Erica Montgomery:
Well, I just appreciate the opportunity to be here and to help people learn a little bit about it, demystify it like we talked about.
Dr. Meagen Rosenthal:
Awesome.
Dr. Erica Montgomery:
So thank you so much for inviting me.
Dr. Meagen Rosenthal:
Thank you. Well, thank you everyone, and tune into our next episode of, The Mayo Lab podcast. Have a good day.
Voiceover:
Thank you for joining us on this episode of, The Mayo Lab Podcast. The Mayo Lab Podcast is produced by Dr. Natasha Dieter, Dr. Meagen Rosenthal, Alexis Lee, Slade Lewis, and Hannah Finch. This podcast was recorded at Broadcast Studio in Oxford, Mississippi. The show was mixed and mastered by Clay Jones, and our original music was composed by Slade Lewis. The Mayo Lab podcast is brought to you by the William Magee Institute for Student Wellbeing. For more information on, The Mayo Lab Podcast, head over to themayolab.com and follow us on social media at The Mayo Lab.
If you enjoyed listening to, The Mayo Lab Podcast, we’d love for you to subscribe, rate, and give a review on iTunes, Spotify, or wherever you are listening to this podcast. This podcast represents the opinions of Dr. Meagen Rosenthal, Alexis Lee, and their guests on the show. This podcast is not intended to be a substitute for the medical advice of a licensed counselor or physician. The listener should consult with their mental health professional in any matters relating to his or her health, or the health of a child.