Mental Fatigue and Emotional Exhuastion

In this episode we discuss why so many of us are struggling with a buildup of stress, mental fatigue, or emotional exhaustion.

TOPICS DISCUSSED: 

-How pandemic isolation affected diverse and at-risk populations

-Flexibility as the new normal for returning to offices and schools

-Can it help to “force” ourselves to be more communicative?

-How to help someone resorting to unhealthy coping mechanisms

-Occasional bad days are OK

Transcript

This is On Your Radar, a podcast series with the physicians and staff from Rosecrance. 

Hi again, I'm John Williams. We record these podcasts at the WGN Radio Studios in Chicago, and this podcast is titled, When the Stress of Everything Becomes Too Much. In fact, we've done a series along these lines about stressors, about the trauma that people experience or have been experiencing, especially lately. And now we're going to talk about what happens when these stresses become compounded. And what can we do? Dr. Adrienne Adams is a medical director of the Rosecrance Griffin Williamson Campus, and Amber Cotter is a therapist at Aspen Counseling, which is a division of Rosecrance. Ladies, welcome.  Nice to see you. 

Thank you for having us. 

It's great being back. 

Yeah, you and I have visited before. I guess under similar circumstances, it's too bad that we have to talk about these sorts of things, but that's what you all do. So let's talk a little bit about this. First of all... do you agree with the premise for this particular episode that not only do we have an elevated baseline, say, with the pandemic, but it does seem like there are more stressors in people's lives these days, that they do seem to be compounding? Doctor, you go first. Has that been your experience? 

Yeah, I mean, and as you know before, I mean, there was already a high amount of mental health illness to begin with, especially for children and adolescents, and that, you know, they were stating 1 in 5 children have mental health disorders or problems. Since the pandemic, it's, gosh, it's increased in so many different ways. I mean, they've recently did a study with high school students that actually two-third of the high school population are having some sadness or problems. So definitely, I would say the pandemic has increased, I would say, the mental health. burden but also it's kind of showed us I guess some of our weaknesses and I think ways for our systems to realize we have to make changes in order to accommodate our patients and hopefully get more kids to have some help. 

And I'll talk about what those ways are in a minute, but Amber, would you concur with the doctor that it does seem to be more evident right now? 

I would definitely say so. I would say with the increase of resource scarcity that we have right now, the availability of resources the timeline in which people can receive these resources, definitely plays into it. And to talk about what Dr. Adams said, you know, definitely some of our more diverse populations are definitely suffering with the pandemic, especially as more traumas keep occurring or reoccurring, and there's no solution, there's no absolution that can really help take the gravity and the intensity off.

Why do you cite diverse populations? 

Such as LGBTQIA+. African-American populations, indigenous populations, people that typically have less access to resources to begin with, or the resources are not easily available to them. 

But are you saying that they specifically are feeling it more acutely or they just lack the resources to help them? 

Both. There's not a lot of specialties, I would say, in certain programs for graduate school and beyond that speaks to the concerns that these populations have. I would also say that, just general resources of transportation, job availability, insurance, these are all barriers that some of our clients were already facing in the pandemic. And then the pandemic compounded this. You know, you have people who are isolating, have no availability to visit with family, which is a big cultural component for a lot of our clients, or not be able to reach out to family and support, or support outside of their family units, which makes them feel more isolated and alone. 

So do you see a spike maybe in the general population, but even more so than in these diverse communities we're talking about?

I mean, yeah, definitely say within the general population. And also, as Amber stated, with the people of color, in addition, Asian-Americans. There's been a big increase in mental health issues for Asian-Americans, especially associated with some of the racism that are associated with the COVID title, even. That's been a big spike. And definitely, as Amber mentioned, with the LGBTQIA plus community, our teens, a lot of times they felt a lot of support, our kids and the school system. And I would say with the beginning of the pandemic, when everything was shut down, they really lost that connectedness that I think all our, we realize in hindsight, that all our teenagers really, that's vital for their development. And so we're even now seeing the aftereffects of having the lockdown. 

We did, well, the president did, some people did for a while call it the China virus, and that did seem to dissipate either with Donald Trump's losing the previous election or it just seems to have fallen out of whatever favor that it did enjoy. It certainly seemed to be derisive. I guess it makes sense, though, that any community that is marginalized at a time of crisis is going to feel more marginalized still. If we've isolated to our homes, if we're working away from the workplace, then maybe we do feel more isolated, right? 

Oh, definitely. 

And for some of our populations, going outside and doing community events is one of their biggest coping skills, right? Group therapy, if we're talking from a clinical aspect, you know, group therapy, alumni events that Rosecrance or other providers have, it helps them feel like they're not alone in their battle, right? And when COVID shut everything down in first week, I believe it was told for six weeks and then it got pushed to like four months, now you have all these individuals at home, not able to access some of their supports and some of their environments are not generally healthy. Not pushing that or saying anything against their environments may be not supportive in the way they need, right. For some of my clients, going on hikes or getting into sports or going on their bowling league and things like that, that was something that they established before COVID and everything got shut down. So then what do you do with yourself, right? And now most people have an array of coping skills, but then you're pushing all of those stressors and all of that energy that you need to dissipate amongst multiple coping skills, and you have to do ones that are driving isolation, driving really... feeling alone. 

Do you find that people are surfacing who would not have surfaced pre-COVID, say a young person who's dealing with their sexual identity. Maybe they were handling that or handling it privately, maybe not handling at all, but suddenly these people are coming forward now?

Oh, yeah. I definitely agree with Amber. I think typically with our kids that were dealing with those, I would say, gender issues that, typically, at least when they were in the school system, they weren't with peers that had similar issues, or at least they had moments of support. They have found that with the pandemic that a lot of the kids, because we were once again quarantined at home, that they no longer had that support system or that ready-made support system, even with school counselors. And unfortunately, there were some family members that were not gender-affirming. That's one of the thoughts that we have for why their mental health issues kind of have increased. But I will say, you know, once again, I look for the silver lining on everything. So I think with the pandemic, we really started working out ways on how, still, to engage with people. So I know even within the school systems, they would sometimes have, like, just get to know you things on Zoom. I know with a lot of our, even with our patients, it was helpful, and I know Amber was telling me this really neat story of when you're doing treatment that a lot of times, you know, the kids or the patients will kind of bring you into their lives, they're able to kind of see their rooms and it kind of gives you that connectedness that is, I think, important not only for therapy but just for, you know, being a human. We all need our social connectedness. 

I mean, literally, they would show you around the room with the camera?

Oh yeah, yes. So, like when we were doing telehealth primarily, I would say in the first year and half of COVID, I would have clients, you know, have their cat walk across their screen, and they'll apologize. And I was like, no, no, no, that's adorable. And I'd be like, no joke, here's my cat Toffee, right, and it would help them alleviate some of that rapport building stage that sometimes we get caught up with because we're prim and proper, and we're sitting in a professional setting with our offices neat and tidy. And here they are, they can see my downstairs office that I use. They can see my cat. They can see some of the artwork that I've done with my family, and then they start sharing some of that as well. I had a client so joyous to share how they redesigned their room, and we're talking about somebody who ,for years, struggled with just basic hygiene, just basic cleaning your bed so you have somewhere clean to sit, somewhere clean to lay without crumbs or anything else, and they were so happy. They're like, being at home drove me because here I am spending all this time I wanted to make somewhere I want to live in and be in and feel comfortable, and that is very affirming for me, and seeing that transformation through multiple sessions was so heartwarming, and they did it on their own accord, and they are so happy with it. 

We're talking about people who had to retreat during the pandemic, but the phase where we are now, and we're sitting here in November of 2022, is that we're reemerging, which I think is its own kind of now awkward situation, isn't it? 

Yes. 

It's either a hybrid workplace, a hybrid school place. It might be that you're coming back but you're not comfortable. Just talk to me a little bit about what people are encountering when they return to work or return to school. 

Well, I think that's really a great question. I think a lot of people were hoping, like, once we're done with the pandemic, it's over and we'll go back to the way things were. But I think a lot of us are realizing that this is kind of the new normal. And, you know, as I said, I think there were some positive things that came out of COVID as far as realizing that, you know, we can be a bit more flexible. We don't have to be sitting in an office 40, 50 hours a day, but we can kind of have more flexibility with our scheduling, which in a way helps improve everyone's mental health. I think if you're able to  kind of do some work from home in a comfortable setting, and also some time in the office where you're having connectedness with your peers, same thing with schools, I think for a lot of our kids, they're able to do a lot of things back in school, but then there's still some things that they might do offline, and it's kind of more comforting. So I think the hybrid system is probably kind of here to stay in various formats, but I don't think it's all bad.  And I'm happy, though, that we are doing, or reemerging, as you call it, because I think it's important, once again, to have that social connectedness. 

But your colleagues and other individuals I've talked to tell me that, if we were talking about young people, say students, have lost demonstrably maturity, social skills, social graces. Would you concur?

I would. The way I understand it is that comfortableness is a demotivator. If we're sitting on the couch, if we're sitting in the mess that is our mess, whether we've created it or it was created for us or a combination of both, we don't want it to change. We're used to it. We know the boundaries. We know how long we can go without taking a shower. We know how long we can go without communicating to our friends, or how much engagement we need to have in a conversation in order for our red flags not to pop up in our family or friends or other supports, right? And as we've shifted from pre-COVID to COVID to after COVID, I would say, and I'm hoping we're staying in that after COVID mark here. 

Fingers crossed. 

Fingers crossed.  You know, we're seeing a lot of people's comfortableness change, sometimes without their consent. You know, you have a lot of... young adults are saying, like, I would rather do online school. It works for me academically. It works for what I need for my time rates. And it also has pushed a lot of families to say, like, we're used to these kids maybe working to help out with the family, or taking on different roles within the family. And it's really challenged as we've asked these kids, go back to school, go back to being a kid, and they're not ready for that or they don't want it, right, and so just really working at where the client's coming from, what changes do they see that need to occur and really figuring out what's demotivating. 

And maybe not everybody's experience at school is all positive. So if there was a click of bullies or if you felt awkward because of your identity or whatever the issue is, every kid at that age and stage has a little bit of trauma they wear on their sleeve, and now I've got to reemerge into that  place where all of this sort of connects, and it can be, under the best circumstances, a hard time for kids. I'm thinking about high school, junior high school, college, whatever. So maybe going back to school is... not an oasis for them. It's a new trauma point for them, especially since it is a little more awkward right now. Do I wear a mask? Am I uncomfortable with the kids who don't? Nobody's wearing a mask in November of 2022, but that doesn't mean that we still don't have the vestiges of a pandemic and people aren't worried about that. I guess all of that to say, maybe we should be mindful of the fact that normalizing our lives doesn't feel so normal to kids and to adults. 

And it really doesn't instigate change at all,right. It doesn't instigate change. If you're comfortable, if you're fine with your normal, what investment do you have to change? 

Sure, sure. So you're arguing to, despite that, go back to school, go back to the workplace. 

Oh, yeah. We definitely need everyone to return back to school. But I think thinking of it more so as an adjustment versus going right back to how things were. Because I feel like we're not in that place of going back to how things used to be, but more so realizing where we are now and how we're going to adapt and go on. So I think with a lot of the schools, I mean, kids have gone back. And you're right. I mean, for some kids, it was more of a, you know, like, oh, I'm away from the bullies. But then, by going back to school, you're learning to work with, I guess, difficult personalities, right? And that's part of growth. I think, once again, the positive about COVID is that I think a lot of the teachers and the counselors and everyone, they kind of realized there's, you know, I think they really were more introspective in realizing things that we can do better.  So even with kids that are having problems, they're able to kind of think about what can we do differently, and what other tools can we use? 

I would also say it's also given us some other opportunities as well. I worked with a young adult who had not finished high school for medical reasons, right? He was enrolled, but he could not physically attend before COVID because of being immunocompromised. So a lot of the homework that he would be sent, it was very much at home. He didn't have any interaction because he couldn't have interaction. When COVID happened and everybody was online, that person thrived because they were able to interact with their peers and actually attend classes via Zoom, and actually attend graduation via Zoom and get this opportunity that they would not have had. Some of those opportunities and resources that we're still using in different ways now have opened so many different ways of kind of, one, addressing this resource scarcity that we have, but also giving more people of differing abilities, whether it's developmental, physical, mental, social, a way to thrive and a way to feel like they're wanted and they're needed and we want them here. 

I wanted to talk a little bit also about the compounding effect, which leads to more than just discomfort, but trauma. What is the evidence of that? How do we see, what do we look for to go, wow, this is... this is advanced to a more acute stage for an individual. What are some of the red flags?

 Well, I know before, I know we were talking about, you know, as far as various things that have happened. And I think with, you know, having the pandemic, one thing that has come into focus has been what we call ACEs, right? Which is typically more so things. Oh, my gosh. 

Adverse childhood environmental situational events. 

Right. And so that's something that was happening all along, but they realized by having the pandemic and having, you know, definitely some families that were impacted more than others, right? So for some families, they had to worry about scarcity of money, right, or being evicted. They had to worry about losing their jobs because definitely for a while there were a lot of restaurants and things that were closed. So for a lot of kids, they kind of had what we would call the ACEs, right, as far as happening to them, where maybe their parents were feeling more depressed themselves or having more mental health challenges so then they're less available for their kids. There might be less financial income within the household, so there's more concern about finances,  such as, you know, food, lighting, heat, those kind of things, right? And also just that emotional connectedness, because as we know, with anyone with depression, most times they are more isolated. There's higher accounts of irritability, and they're just kind of like not themselves. So I would say that is something that we have noticed. And as we're still learning a lot about COVID, but one of the things that we have noticed about COVID was that it was a different type of trauma that, you know, as a society, we're not used to. I mean, I think the last big pandemic was the Spanish flu. So and none of us were born back then. But so, yeah, this has been a learning experience for all of us. And so I think we're going to continue to study and see all the ramifications of it. But that's something that's been more immediate that we realize that a lot of our kids and adults, our young adults as well as older adults, have suffered a type of trauma by having the pandemic. 

And, Amber, you made me think when you described a child who had a physical reason to not be able to interact. 

Yes. 

I'm thinking about a list of stressors that can become traumatic in this environment we're in now. It wasn't a physical injury, but physical injury, emotional stress, abuse. bullying, divorce, kids that live in poverty, adults that live in poverty, people that suffer from addiction or mental illness. Take any one of those or any combination of those, and now the pot's boiling even faster, isn't it? 

Definitely. And if you have already a pre-existing scarcity of resources, and then you, on top of that, have a pandemic, and other events that are currently going on, you know, mass shootings, racism, blatant homophobia, right? And you throw that in the mix as well, now you have people who are doing one of the biggest red flags of trauma, and that's avoidance behaviors. We as a human race, I would say, we avoid things that hurt us. It makes sense, right? But with trauma, you avoid things that help, um, spark the idea of trauma: the emotional connectivity of trauma, the physical reminders of trauma. And if that's a school, if that's a workplace, if that is now certain community centers, the libraries, I've heard now, restaurants, because of how people are responding to community events that are being held on um 

You're saying people are retreating to those places? 

No, I'm saying people are staying away from. So I know there was a place, I believe in Lake in the Hills, Illinois, where they were having a reading time with somebody who was dressed in drag, right? And it was something that was pre-existing for a while now. And then there was this negative response and they had somebody put slurs up on the walls and, you know, destroy some of the property and it got shut down for a while. And now you have people who are afraid to turn to that community resource because they don't know how they're going to be responded to if they're seen there,right, something that used to bring them connectivity and a sense of belonging. And so then we start further retreating and further avoiding things,and then we're losing that sense of where are we coming from? Who do we belong to? What do we belong to? 

So if the next part of this conversation is what are coping mechanisms or what are, what's the thing that we should do, either cope with it or seek professional help or some combination thereof.  But just give me a few more examples of things that I would see in myself or somebody else to alert me to the need for these resources. And if it's retreating, maybe it's a little harder to notice, although I guess you could recognize the absence of somebody's participation. But maybe there are other red flags. I don't know what those would be. 

And, you know, and I guess I, once again, because I hate thinking of doom and gloom all the time. I mean, most kids are going to be okay. Most people are, you know, we're a resilient group. And so I would say for a lot, majority of us, we're able to kind of use this pandemic as a way to kind of reunite. Kind of, you know, there's a lot more human kindness among each other, so, I guess I want to make sure that we realize that, yeah, most people are fine. But for the ones that have had more challenges with it, I think things to think about to kind of say, you know, maybe there could be something more,  I would say it's what we call emotional fatigue, right, or the mental exhaustion. And I think of it as, say, when you run a race and so physically you're just exhausted, all you can do is just lay out. And, you know, your muscles are tight, everything hurts. So kind of the same thing I would say with mental exhaustion. You know, it's just you just can't even think. Your concentration's off. You're easily distracted. You find yourself more irritable. And it's like no matter how much you try to refuel, you just continue to feel exhausted as far as not being able to get anything done. And that definitely can affect you both at work as far as, you know, you could get behind on your projects at school, not turning in school assignments. Even in relationships, you find yourself being more isolative, less engaged with others. And, you know, once again, everyone has a bad day here or there, but if you're noticing this happening for weeks at a time, I would say that would be definitely kind of a red flag. 

I would definitely agree with that. And I would maybe add, you know, feeling inappropriate guilt and shame, feeling that maybe you deserve this or that you deserve pain in general, or you don't see a way out, you're feeling helpless and hopeless, and you don't have that control in your life anymore. You feel like you don't, right? And it can... start trickling down to like, I can't figure out what to wear today so I'm just not getting out of bed. I don't know what to say in a conversation, so I'm just going to be silent. 

And why try? Why try anymore, right? I just give up. 

Exactly, and it just continues to compound and compound. And I love that there is certain clients out there that I've been receiving referrals from who are starting to catch that and starting to listen to these podcasts and other self-help talks, and realizing, like, that is not a road I want to go on. And I would say the pandemic has really started to bring those people out, and trying new resources like listening to podcasts and watching certain talks on the show, that helps them really realize like, wow, that maybe is a warning sign, right? If I'm thinking I deserve this guilt and I deserve this shame and I'm more irritable and I have less patience and I just don't want to be here anymore, and saying, okay, let me do something about that. 

Yeah. And I think being more introspective, too. You know, you're able to kind of realize, like, you know, I'm really not happy with what I'm currently doing. And maybe thinking about, you know, maybe it's time for a change. I feel like I've seen a lot of people since the pandemic kind of change their career, or change a lot of things in their life, decided they're going to start running, or doing 5Ks, or in the past they were sitting on the sofa. So I think it's also a time to kind of spark a new interest or allow yourself to be that person that you always wanted to be. 

Yeah, Dr. Adams, would you say that some of those people, I think you just answered that question, may have been living their lives that way pre-pandemic. They were in a stasis, and they were existing but not flourishing. And this has maybe been an impetus for them to try and improve their lot, or be more proactive about how they feel.

 Instead of being a bystander anymore, they're trying to really take control and figure out what were their priorities and what should their priorities be, and that could be a drastic difference. I've heard some clients say, like, I used to work 60, 70 hours a week. Hardly ever see my family. You know, I would maybe spend one day a week doing my passion, and now they've turned it around and now they're working from home 20, 30 hours a week. They found careers that work for that, and they're able to explore their interests. I have a client right now who is trying to visit every state park in the United States, which I think is imaginable and so, so beautiful, right. Or I have a client right now who has some physical concerns right now, and so they're making shadow boxes for people, just like out of scenes of movies, and just taking that time and crafting and doing this act of service that is part of their love language, but being able to give it to somebody else instead of just sitting there and saying, well everything that I can't do anymore. Well this is something that they can do.

And even gardening, because I've had a couple of patients now that, you know, with the beginning of the pandemic, since, you know, at times things weren't available at the grocery store, but they realized that they, you know, couldn't garden, so they actually started growing some of the vegetables, you know, things that, I mean, we have a bad, not bad, we have a challenging climate here in Illinois. But with that being said, they were able to actually, you know, plant more time in some of the... herbs. Spices and herbs and things like that. And they enjoyed it. And so now, even though the pandemic is at a different place right now, they're able to still do gardening with other gardening groups, other gardening enthusiasts. 

And I would say that actually speaks to building rapport with some of our clients as well because most of that is within their economic availability. And it's something when you say like, hey, what did you do during the pandemic? I can say to my client, well, you know what? I also build a garden box. I'm growing tomatoes and hot peppers. And we try corn. That does not work in my backyard, we learned the hard way, and trying different things. And they can see, like, wow, if Miss Amber can do this, I can try. How do we start this, right? Or, you know, getting into different interests and being able to share that with them and seeing like, you know what? Yeah, maybe today was a tough day. Couldn't go out, you know, especially when we have six degree weather in Chicago. Well, what can we do on the inside? We can build something. We can create something. We can be constructive. 

But do you imagine that people will come to that conclusion themselves? We're talking about people who maybe lack resolve right now. That's why they're feeling this way. So how do we get them off the dime? Or how does an individual suddenly come to the place where they're going to help themselves more.

You know, and I think that's one of the great things about our podcast. I think, and as Amber mentioned earlier, a lot of people are trying new things,  so I'm hoping that, you know, part of, you know, the result of the podcast is that they'll be like, oh, I hadn't really thought about that. Or, hey, that kind of describes me a little bit. And then they'll actually want to, like, get more information. And, you know, so that's one way. I think definitely with the kids being back in school, that's definitely another big way because a lot of times teachers who are working with the kids, you know, eight hours a day, social workers, they're able to kind of notice if there's a concerning issue and, you know, bring it up. And, of course, I think our parents, you know, I think another positive thing about the pandemic with, I guess, being forced to work from home, is that a lot of parents were able to spend more time with their kids. And they were able to really kind of see what some of the kids are up to. And, you know, I think for most, it was a really wonderful experience. But I think for some parents, they realized like, hey, my child's really  struggling right now, and so I need to get them some help. 

And I would say that, being that our providers and some other providers in our communities still offer telehealth, it does help address this resource scarcity, right. We can get a refer from a school, from a hospital, what have you and we can work within their time frame of like how can we get them help in the environment that they are in, see what's going on, and really build a treatment plan that will really work on so many different levels, such as the environment, their support system, their coping skills, their emotional availability and awareness, and those people around them as well as themselves.

I wonder if you force yourself to be more communicative, if in fact that will work. It'll be therapeutic for you, even if you don't feel it, even if it's like a muscle you have to exercise to talk a little bit more and express a little bit more, if in fact that does have a positive value to a person, you know. I mean, maybe I don't feel chatty because I am despondent because of all of these circumstances. I wonder forcing myself though to, the same way maybe running when you don't want to run you know is going to be beneficial exercising, you know it’s going to be beneficial. Maybe being more communicative, even if it's forced, is a step in the right direction.

And definitely reaching out to the supports now available, whether virtual or in person. I mean, I have a client right now who is attending NA groups online in New York because it best fits their schedule. And before pandemic, that wouldn't have been the thing, and it would have just been another barrier to their treatment, and they've been sober for seven months, which is mind-blowing. 

That's awesome. 

Sober for seven months during the most challenging time to be sober in their lives. 

Right. Or there's now caregiver support groups that can be virtual online. So, my clients who are taking care of the elderly, taking care of somebody within their home or their support system that does not have, I would say, some other abilities and feeling that support like they're not alone in this. Now they have that, right? Or some of my clients who have struggled with self-harming, whether it's verbally to themselves and being abrasive or physically to themselves, now there's groups that they can attend, right? Some of the pandemic, I would say, has definitely developed these groups that are flourishing and really helping.

I've heard of people that harm themselves, cutting and so forth. What's a verbal version of that?

Um, self-deprecating comments to yourself, you know.

Worthless, you know, I'm no good, you know, I don't deserve this. 

Do people express that out loud or they just think and feel that.

 Oh, I’ve had both.

I’ve had both, yeah, both.

Really?

 Yes, and figure we know us the best, we know our weak points. Goodness gracious, I can tell you how weak my knees are in the winter time. And if we're having this self-deprecating thoughts, I would just like, oh, of course your knees are weak. What's wrong with you? You're so, you know, weak there ,you're not strong, and then just keep picking at and picking at it and just bring your self-esteem and self-worth so much lower that it really,  just becomes part of who you are, right. 

And you could see that spiral into overeating or drinking or doing anything that if you feel you have no worth, if you feel you're not a valuable commodity or person, then you don't begin to treat yourself with any dignity or respect. 

Yeah, and I think typically we do see a lot of what we call self-medicating, we call it, but a lot of times, and…That's definitely something that I wanted to bring up. I mean, for adolescents, that is something that is a concern as far as, you know, increased substance use, sometimes with alcohol or marijuana, cigarettes. I would say with the school, being back in school, maybe something to kind of think about because a lot of times, I guess with vaping, it had gone down, but now school's back, so it's kind of going back up because that is typically a place where kids will vape because they're able to get a vape from a friend at school.

You see a lot of that? 

Sadly, yes. 

A lot. 

Does that bother you as much as alcohol or cigarettes or marijuana, vaping? 

I would say that, weirdly, it's a coping skill. They get something out of it, but it's not helping them. Whether they get the reprieve of what we used to know in the 90s is a smoke break. You get to step away for five, ten minutes, take a deep breath, recollect yourself and come back. Now they're doing it by vaping. Now they're doing it by smoking weed or drinking. It is not helping them outside of that instant gratification of I have a brief solution that can help me disconnect, right? And in fact, it can further compound some of their financial, social, emotional support issues. 

If people are saying like, that's not the good choice to make. I don't agree with you. You're spending all your money on this. And it can just really further compound. So I'd say part of therapies, too, is not adjusting, or not just developing coping skills in general, but also identifying what unhealthy coping skills are you turning to? How and why are they providing relief, and what can we turn to instead? 

And sometimes it takes a while to realize that it isn't helping you. So I think that's where families kind of come in because a lot of times people outside can kind of say like, hey, this is really not helpful. It's not good for you. Whereas if you're living in the moment, it's harder to realize like, oh, but no, I'm feeling so much better when I do. 

So how do I approach somebody about that? What do I, what's my strategy when I'm going to try and intervene a little bit? 

Yeah, well, I think definitely, and Amber, you jump in too, but I think definitely the biggest thing is not to come off as a authoritarian, like, you know, demanding or shouting because it's just going to lead to a power struggle. But I think as a parent, just kind of, you know, mention like, hey, I'm noticing some changes and just having, trying to have that open, honest conversation and that, you know, I love you and I'm really worried because I feel like you're hurting yourself and I want to help. I think it's one way to kind of start it off and just kind of, yes, starting a conversation and then saying, you know, I think we're going to get a referral and maybe talk to our pediatrician who can then refer us elsewhere. Or, you know, definitely there are different places that you can call right away just to kind of get a consultation. And as I always say, I'd rather have the consultation and we say, oh, you know, you're okay or you're fine versus assuming things are okay and not getting that consultation and then things kind of worsen. 

And I would also say developing a support system that really encourages healthy coping skills.  You know, this is where, you know, turning to your park districts for… some of them have a free-to-play program, as Rockford does and Chicago does, where you can show like, hey, I don't make enough, and they'll let your kids play the sports for free, right. They'll let them participate in the programs for free and really getting them involved in different aspects. But again, there's that transportation issue sometimes our clients run into. 

Yeah.

But also finding, what can I do to help be part of my kids' lives and different aspects like that? Because like she said, if we come from an authoritative position, and I know this as a parent of two kids, all you're going to get is that power struggle, that yelling, arguing, you don't know me, you don't know what I like. It's not going to really give you that solution you're looking for, right? If your solution is like...helping them see different coping skills, helping them see like maybe this isn't healthy. This is maybe introducing them to other coping skills as a family time, you know, board game nights. I mean, at my house, we have pizza night every Friday for the last seven years. We even make our own pizza. 

Oh, wow. 

Right. Which gets a little messy with a three-year-old. But it's something that they enjoy doing, and it's part of our repertoire now. You know, doing things like that. 

And family walks. I mean, that's something. We actually purchased a little puppy. 

Oh, goodness. 

Yeah, now he's 16 months old. But, I mean, I think one of the things, you know, maybe like as a family, you know, doing the family walks, taking turns, caring for your pet. And, you know, and just going to the park. I will say I saw a lot of families actually going to the neighborhood parks at times, you know, during COVID and even post-COVID. Because I think for some it's become part of their family routine. 

And also finding things in the area that are perhaps free or very low pay. I know like Home Depot has the first Saturday month you can get their take and make kits and you can make these cool kits with kids with bookends and cookie trays. The Museum of Contemporary Art in Chicago has it where you can pay how much you can afford. 

Farmer's markets. I saw a lot of farmer's markets. I think a lot of the western and surrounding suburbs, as well as parts of Chicago, they have the farmer's markets where you can kind of go and buy some vegetables at a much cheaper price that are locally grown, which, once again, we're kind of supporting our local farmers, which I think is really important. And definitely, as you had mentioned, the crafts. I mean, I think a lot of parents really took that initiative to do more crafts with their kids. And there are a lot of... DIY kind of kits where you can kind of like pretty much make everything. Bird houses. 

We made a trebuchet the other night. Let me tell you, my floor was covered in marshmallows for a while, but they had so much fun doing it. They didn't realize they were doing science. They didn't realize we were doing family bonding. They just said, oh, mom and dad said we can throw marshmallows? What? 

Yeah. 

You know, though, listening to the two of you talk about all these good ideas and it's... A spontaneous, nice litany of coping skills, mechanisms, ideas. One thing that I'm also hearing you say, though, is it's not just enough to have a talk, that you've got to get involved, either as a loved one or a parent or a friend or a teacher, that it's going to be work if somebody is really feeling traumatized by their individual circumstance and then the pandemic and how weird life is right now.  It's going to take physical effort. It's either exercising, or it's walking, or it's crafting, or it's going to the grocery store to buy the fixings for the pizza because that's what we're doing now. But, I mean, it's not easy necessarily. 

And the amount of work that would be ahead of somebody, especially if they have a limited support system, they could be like, wow doing all those things, making time, getting dressed, going to those places, that's a lot.

By the way, I hate jogging, and I don't want to walk either.

 Exactly, right. Then it's like, okay, let's play with sports. You know, some libraries let you borrow equipment, rent the equipment, and rent video games now for free, right? Let's have a video game night. Very low to free costs. 

 Yeah, may I intervene? 

Yes.

The uh, kids' phones and people's phones. 

Yes. 

How much are those helping? How much are those hurting in our discussion here? 

Yeah, I mean, I always recommend having a, not to say limited, but a maximum amount of time, right? So I know with the American Academy of Pediatrics, I believe they say like one hour.

Really? A day? 

I think, yeah. 

Or every other hour? 

Yeah, I know. But I think really, you know, on one hand, I think technology is helpful because I think kids can definitely look things up and, you know, they've been able to communicate with people that normally they might not be able to, right? They've been able to see different podcasts, maybe like ours, or various things that they might not be able to. But also it goes back to that social connectiveness. So I think it's really important for families, especially at dinner time, meal time, to kind of everyone agree to turn off the phones. Or when you're doing your family night, everyone agree to turn off your phones. I do tell this to a lot of my parents that I work with as far as at bedtime, that adolescents especially tend to like have their phones with them all night and, you know, that blue light from the cell phones is really not helpful for sleep, so I do recommend to my parents to actually have the kids give them their cell phones because it could be temptation. I mean, kids might say, like oh I'll turn it off, but, you know, maybe they need that one more phone call from a friend. 

Just think how easy it would be to get the kids out of bed in the morning if they didn't have the phone if it was in the kitchen. Or wherever else you want them to next arrive. 

And, you know, definitely keep in mind, why is the technology being used?  You know, Dr. Adams definitely brought up some good points about, you know, connecting video calling people that we wouldn't be able to or just visiting people. Like I had family that were in nursing homes during the pandemic that we would not have been able to visit without that. So did we count that as our electronic time? No, that was family time. Right. Or when we would play, you know. video games with our friends in Colorado or our family in California, did we count that as electronic time? No, because it's still bonding time, and we're watching, we're participating,  it's everybody together. But the mindless scrolling with apps that have been coded to keep our attention and it's really not contributing to how we are doing in a positive way , yeah, there's a limit that I would say we have. And I know for at least my family, we have about 30 minutes of TV a day with our kids. 

Wow, you're good. Okay. 

And that has to be like... 

No, you're awful. 

Well, and it's hard because my seven-year-old will say like, well, so-and-so has a phone and so-and-so can go on this. And I was like... we're going to watch YouTube, we watch it as a family so I know what you're watching. We watch, typically, you know, size show or slow-mo guys, something scientific, something that'll catch their eye. Or they wanted to know how rice was made the other day, and I was like, we can look that up, and that's how the internet can be beautiful. But then there's also a lot of those messages out there, like those ads that pop up, even for kids' videos. And I was like, why is that popping up? We were watching some ABC 123 with my three-year-old, and they popped up some political ads about abortion. And I was like, this does not need to be out there. 

Oh, wow. 

Before we wrap that up, any last things you two want to say in this podcast before we say thank you and move on?

Well, I just want to remind our listeners that really think about as far as the mental exhaustion and the fatigue, it's not just something you get over if it’s really impairing your functioning both with work or your family interactions. If you're noticing that you're more irritable, you're not sleeping well, and this is happening for, you know, weeks at a time, it's really okay, and I would, you know,  really I implore you to just kind of find someone to talk to. I mean, definitely, you know, there are a lot of places, resources out there, both, you know, your pediatrician or family, you know, primary care doctor, can recommend, or even services like Rosecrance that we definitely are here to listen. 

And I would definitely say, you know, really being mindful about what, what do you want your end to be, right? Do you want your end to be where you're, you're hard to get out of bed every morning, you're not looking forward to everything, or do you want to have it where you're looking forward to waking up and the adventures that you can take, and that's such a different mindset to have. And therapy, talking to your doctors, getting a team on board, can help you get there. And it is okay not to be okay, and I want to stress that. And we can all have our bad days, like Dr. Adams said, but you should not be alone in your bad days, and your bad day should be a bad day. 

Yeah, that's a good way to put it. Make that the exception, not the norm. 

Exactly. 

And you're really never alone. I mean, that's the thing. There's always someone to help you. And we want to help. 

And we want. That's why we're here.

And that's the voice of Dr. Adrienne Adams, Medical Director of the Rosecrance Griffin Williamson Campus, and Amber Cotter has also been here, therapist at Aspen Counseling, which is a division of Rosecrance. Ladies, thank you. 

Thank you so much. 

Thank you. And hope to come back soon.

This is On Your Radar, a podcast series produced by WGN Radio and the doctors and clinical staff at Rosecrance. With over 60 locations throughout Chicagoland, Northern and Central Illinois, Wisconsin and Iowa, help is just a click or call away. 

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