Podcast Episodes

Speaker: 00:07
Hey everyone, welcome back to YNA Mental Health. Today's episode is one that honestly more of us need to hear about. We're talking about sex, but not just what the act is, but we're talking about communication, shame, parenting, and pleasure. I'm joined by a sex therapist, Janet Diept, who here's help us unpack all from navigating mismatched desire to talking with our kids about sex. Whether you're single, partnered, or just figuring yourself out, this episode is for you. Hi Janet, welcome on to the podcast. We're excited to have you here. I know that you have been doing this for a while. So would you like to just jump into your background about why you became a sex therapist, why you even became a counselor?

Speaker 2: 00:44
Hi, Sina. Um, thanks for having me on here.

Speaker: 00:46
No problem. No problem. We're excited to have you here.

Speaker 2: 00:49
Yeah, so why I became a therapist to begin with, so this is actually a second career for me. I spent a good decade or so in healthcare administration. So I just I kind of had enough of being behind the scenes. I wanted to be in directly working with people. So went back to school, got my master's, decided to go into therapy. And then when I graduated, I was like, okay, what next? And the field of sex therapy was actually always really interesting to me, mostly because I grew up in a household that where sex was such a big taboo, and that I grew up with so much misinformation about sex. I just wanted to kind of be the person who went out there and would just ask people about their stuff and ask people what they knew and just get really curious and work with them and just kind of take away some of the taboo when it comes to talking about sex.

Speaker: 01:45
It's funny that we talk about taboo because I feel like when it comes to sex and all of this, it is all taboo still. And it feels like the stigma still hasn't been breaking broken around any of it. But I feel like when it comes to communication, it plays such an impactful role in just any part in a relationship or anything. But I think the one thing that a lot of couples are scared or even single people who try to have or having partners that they're trying to grow with, they just want to be able to have the conversation. So how do we start the conversation with our partner about sex, especially if we haven't talked about it openly enough?

Speaker 2: 02:16
That can be really hard because I feel, like you said, on the topic of tabu, we are just not taught to give it a voice. So really the first thing to do, I will say, is just to get comfortable talk, kind of acknowledging that you have your own desires and you have your own things that you would like to communicate with your partner. And then when you get kind of comfortable with the fact that you also have needs that you want to discuss, that you you set aside some time to talk about it. It's scary to kind of go up to your partner and say, Hey, I want to talk about our sex life. But I feel like it deserves its actual time. A lot of people, when they don't do that and they have this desire to bring up something that is concerning to them or something like a want or something, they will wait until it's like right before they're about to have sex or right after sex, which is probably the worst time to have those conversations. So yeah, it's there's nothing, no one wants to hear the hey, when you did that, I didn't like it, like straight after sex. Like that can be that can be really hurtful for a relationship. So making some time to actually have a conversation, even if it's just like Saturday morning coffee or something, say I just want to be able to talk about our sex life. And you talk about what you want, talk about avoid any kind of criticisms and stuff. In therapy, we always the one of the first things we always teach is I feel needs. Right. And so you take accountability of how you're feeling about things, and you you kind of just openly say, I would like to try something different, or I feel like we're not having sex as often as I would like. Can we have a conversation about this?

Speaker: 04:06
You know, I think where where you kind of hit it on the spot is different sexual desires, right? And where we stand on one of our partners wanting more sex than the other. And I think for a lot of partners, trying to get an understanding of what that's like and how that they can replicate that into their bedroom is really hard, especially if one desires sex more than the other. And then trying to make time for it, especially with everyone's busy schedule these days and whatever life is throwing at you. But it's not unusual for spouses to have different levels of sex desire, is that right? But I know it may cause a strain in relationships if the couple doesn't manage their differences when it comes to the bedroom. But what happens when one partner has a higher libido than the other? What and how can we solve that issue?

Speaker 2: 04:52
So sex, just like any relationship stuff, is a lot of it's about negotiation. It's really difficult sometimes to discuss because when we're talking about sex and we're talking about libido, we're also acknowledging that there's a a lot of people will tie their confidence to desire. And if their partner's not desiring them, then it it can impact their confidence a lot. But the truth is not everyone has as spontaneous desire as what Emily Nogatsky will call it. A lot of it mostly women will have a responsive desire response, and they need to be aroused before the desire comes. And so that's usually what happens is we have one person in the relationship who has they will say a hi libido, but really that's just spontaneous desire. And then the other person might have a more reactive desire. So they they need to kind of get into the mood before the desire comes. When you have two differences like that, and it is very, very common being able to talk about it, being able to figure out what actually helps turn your partner on, and then finding ways to kind of include that into your relationship, into your intimacy that kind of will help kind of like bridge that gap more. Something else that people hate to talk about is scheduling sex. Sex really should be scheduled. Life happens, we schedule everything else. There is nothing wrong with scheduling sex. So, of course, I'll get someone in my office sometimes and they're like, I want to have sex every day. Their partner's like, Well, I can probably go maybe a couple of times a month. I do think it's really important to have intimate time on a regular basis, but intimacy doesn't have to mean sex. Intimacy should be something that occurs on almost a daily basis. But again, that doesn't mean sex. It just means holding each other longer, communicating, telling each other that they look good, or saying that I love you and having the hugs and just that closeness. And if we can make a point to prioritize that, then sex happens a lot more frequently.

Speaker: 07:23
You do make a really good point that we need to stop looking at sex as like just intercourse in general, but like really focusing on the intimacy aspect of it. Because I feel like a lot of people do struggle with that is how do I continue the intimacy? And I think the bigger question behind that is like people in relationships for years on years on years who go through the daily routine of getting consistent and just falling into this pattern of life, they lose that intimate sexual desire for their partner just simply because life does get in the way. I think the question is for couples who have been through the journey, whether they're married for years, 20, 30 years, or whatever their relationship has now gone on to, how are they able to continue creating intimacy in their relationships? Is there anything that they that you recommend trying new things, trying new hobbies, maybe even bringing sex toys into the bedroom that could help increase maybe the intimacy levels? How do you believe would be the best way?

Speaker 2: 08:15
I mean, sex toys are great. Trying new things is great. But really, it's just making sure that you still flirt with your partner. I think that's the biggest thing. I when you get comfortable with someone, sometimes you just stop putting in so much effort. So the biggest thing if I could say to people just to just to keep flirting. Actually, one of the things that I say to all my people is, and I'm not sure this is safe for podcasting. Go ahead. Is actually I'll say it nicer. Flirting starts after the last orgasm. Yeah. Or foreplay starts again after the last orgasm. And so just remembering that this is the partner that you chose, this is the person that you chose to spend the rest of your life with. You're not gonna flirt with other people, you're not there to impress other people. And so just take in a few times out of the day just to send that nice text message, even if it's when you're in the bathroom. Yeah, everyone, they go to the bathroom, they whip out their phone, they'll look at Reddit or something. No, just send a sweet message to your partner, thinking of you, hope your day is going well. Nothing wrong with that.

Speaker: 09:22
Yeah, and I think that's so beautiful to say is like what I've always remembered and being told by like my therapists and just people who've had so much knowledge into relationships is that you shouldn't stop dating your partner, right? And we get into these fields of like constant motions of not putting in effort and just getting stuck in life. And I think that's what's scary for a lot of people. I think that's scary for myself, even in a relationship now. Like, I'm terrified of losing the love I have for my partner just because I get comfortable. And being comfortable can be really scary for some couples, especially if you've been doing it for so long, especially if you've been together. And I think another part that plays in a big question is what boring sex means. Like a lot of couples probably have a weird way of defining what boring sex is. But I know it means different things to different people.

Speaker 2: 10:06
I'm assuming they're talking about the routine.

Speaker: 10:08
Yes, probably.

Speaker 2: 10:09
Everybody has their own kind of sexual routine, even down to the hey, we start off with this position, then we switch into this position, and then we finish in this position. Yeah. Right? Or they might just have the one position and it's on a Wednesday night after the kids have gone to bed, and yeah, so it can get very routine. I wouldn't necessarily call it boring. For those situations, there's usually a reason why it's considered boring. What is it that you feel like you're missing? What is it that you want to try? That's when we start talking about fantasies and and like, is there a toy that you saw, or have your have you been talking to your girlfriends about something specific that they tried? And and then you start reflecting on your own relationship and you're like, oh, wait, like ours is always the same. So again, it goes back to that communication again, you know, being able to talk to your partner about what what it is that you would like to to do that's different.

Speaker: 11:10
And when it comes to communication, I know that we are going to keep hitting on it all all this time. This whole episode is just going to be focused on reminding people that communication plays an important part. So I gotta ask you, what does good communication look like from the eyes of a sex therapist?

Speaker 2: 11:23
From the eyes of a sex therapist, it's being able to just say what's on your mind with kindness, of course.

unknown: 11:32 Hopefully.

Speaker 2: 11:33
Hopefully with kindness. But being able to say what you what you need to being able to just communicate what you need and having your partner meet you without judgment, with with your partner just being very curious and willing to explore it with you. It's not just sex, like you said, it's all anything. Anything. Even if I woke up in the morning and turned to my partner and said, I want to buy a bigger house. Rather than him saying, No, we're not buying a bigger house, I would want him to say, you know, why why do you feel like a house isn't big enough? You know?

Speaker: 12:06
And I mean, in the beginning, like everything they say, the three deadly horsemen that kill your relationships is sex, money, and miscommunication. You know, how big communication plays in a lot of relationships. And like sex, I feel like communication can become constant and just become in this routine. Like you've said the same things, but we don't desire new things, or we're not trying to say different things to our partners to maybe get a better understanding of what they're dealing with and how they're or what they're struggling with. And I think this is where mental health plays a really weird place, is like mental health and sex are usually not put into the same sentence. But now that mental health has become such a bigger thing and people are talking about their mental health, that it does play effect in your sex. So I have to say, like when it comes to mental health conditions like anxiety, depression, or any other type of disorder, how does the mental health play a part in sex?

Speaker 2: 12:53
Mental health is the biggest, biggest player. This the biggest, the largest sex organ is the brain, right? So if you're if you're feeling anxious and you're feeling depressed, you're feeling like too stressed out, you're not able to rest your brain, how are you gonna find that desire to be intimate? How are you gonna find the time and space to meet your partner where they're at? Because the the only thing you're really focusing on is like how to get through the day. And when you're trying to focus on getting through the day, the last thing you want to do is have sex. And I guess I speak that more for I think more for women, although it's it goes across the board too. Because for some people, sex is the escape as well. Sex can it's like I'm so stressed out, I just want to have sex, so I can fall asleep, right? So it's it becomes sex is a symptom. The having too much of it, having too little of it can be a symptom of another mental health struggle.

Speaker: 13:52
And then having that open conversation with your partner can be scary, especially if it's something new that you're dealing with inside. And I we always recommend on this podcast to see a therapist and see a counselor, and even a sex therapist would really help and kind of get a people a better understanding. But I know that that a lot of people do take medication for their mental health and how medication can play an important role and where where you stand in your chemical imbalance or whatever you're struggling with. It says mostly antidepressants are something that a lot of people take, but it says that estimates of sexual dysfunction vary from a small percentage to more than 80% just because of SSRIs. So, what SSRIs have the least sexual side effects, and how can I address with my therapist like that, or my psychiatrist, that hey, my my sexual desire has increasingly decreased. How do I, how do we fix this?

Speaker 2: 14:38
So there is no your doctor will tell you these ones have the least side effects, but everybody is different, and we don't know how SSRIs are going to impact you. For some people, they will abandon you an antidepressant too soon because the initial effect is is quite can be quite strong. But for a lot of people, they will stay on it and then over time the their sex drive will come back. But of course, there are some people who will get on at SSRI and they have zero desire ever again. And then we talk about okay, so what do you still desire? Can we find a way to get some of that back? If you're single and you're on an SSRI and you know desire and this is the best thing in the world, we don't need to change it, right? And so it's just kind of like figuring out where your body is. But for people who do try it and initially they see that kind of dip. I would always recommend you talk about it with your doctor, talk about it with your therapist, talk about it with your partner. Or, you know, if you're coming in to see me, I'm gonna ask you, okay, what is it that you do still want to do with your partner? You know, what kind of intimacy are you guys still having? Because we don't want to manage the depression but ruin your relationship.

Speaker: 15:50
Exactly.

Speaker 2: 15:51
So we want to find ways to meet in the middle. And then usually as the drug gets kind of like settled into your system, a lot of times people will report that their desire comes back.

Speaker: 16:03
And that's great. I think that's something that a lot of people will be afraid of, especially when it comes to medication, especially where it has the massive chemical imbalance.

Speaker 2: 16:10
But they also prescribe it for certain conditions, like a premature ejaculation. Sometimes they'll prescribe a SSRI just to kind of help delay, delay that.

unknown: 16:20 Yeah.

Speaker 2: 16:20
So it it can also be beneficial in the bedroom.

Speaker: 16:22
Yeah, so definitely something for people to look into, you know, definitely have a conversation with your counselor and definitely have a conversation with your psychiatrist to figure out what's right for you. Again, communication playing an important role in life in general. So who would have not me, I guess. Yeah, I kind of want to switch into like the conversation about the bedroom and how I think one of the craziest conversations and kind of affects a lot of people these days, and I didn't realize till I did the research, is how to quote unquote perform in the bedroom and how performance anxiety plays such an effective role in relationships, especially when it comes to something that's so intimate with the other partner. It's even been said that approximately 25% of men and 16% of women have sexual performance anxiety. But what is the best way to reduce that for both male and females?

Speaker 2: 17:07
The short answer?

Speaker: 17:08
Quit performing.

Speaker 2: 17:10
Quit performing. It's not a performance. It really sucks. And I blame media because it's how media portrays it. Like you need to you need to go in and you need to look like a porn star or fuck like a porn star, as they'll say, or sex should not be a performance. It should never be a performance. It is about intimacy, it's about connection. And we just like in life, should be able to show up in the bedroom however we show up when we when all of our guard is down with a partner. And so if we mess up in the bedroom, if we need to be able to laugh at it. You want a partner who hey, we tried this, it didn't work out, we all looked ridiculous, right? Like my belly was hanging over here and it looks terrible. Oh well, like let's laugh about it. Let's just we're not gonna do that one again. When you go into the mindset of, I need to go in, I need to last this long, or I need to be able to ride like I'm a cowgirl, like it then yeah, you're gonna you're gonna struggle and you're gonna lose that that closeness with your partner. For people who do have performance anxiety, we go back to basics. We talk about let's rediscover our bodies. There's a technique that I will do with my with my clients where I just have them grab like a pen. I don't know if you want me to show you. Let me. And I'll have you do it, aren't you?

Speaker: 18:43
I don't know if you can do it because you're holding a microphone.

Speaker 2: 18:47
But I would just have them grab a pen and make a fist. And I just have them start kind of just stroking along the hand with the back of the pen. And I tell them to just notice how it feels. And for the most part, they'll like that they'll be doing this, and they'll be like, Yeah, yeah, I guess I guess it feels pretty good. And then I'm like, okay, well now open up your hand and I want you to start kind of tracing the inside of your hand and notice how different it feels now. And now I want you to go to the inside between your fingers. And then they're like, oh, that tickles. And now they're understanding, okay, this is the purpose of this. Like now you're finding out what feels good, what doesn't feel like much, what tickles, what you don't like, what you do like. So all that is is just mindfulness. I got out of my head because at first he's like, this is ridiculous. What am I doing this for? And then they find all those little senses and he's like, oh that feels good. That feels good too, right? And so when we can when we can do that with our partners or even by ourselves, it just gets us out of that headspace of having to perform. It's like, oh, my partner touched me along the jawline and it felt so good. Or he kissed me in the back of the neck and it's and it sent tingles down my spine. Like that is the stuff that we want to get back to because when you're thinking about, oh, that feels so good, or her response was was like, Oh, she melted. You're no longer thinking about what you have to do next. You're just really enjoying that moment. And so for some people who really struggle with performance anxiety, we just take sex off. We just say, let's just just let's just not think of sex. Let's just think in a let's just think about exploring our partners' bodies. And they will get comfortable. A lot of times when I say you're not having sex, they'll come back next week and they've had sex. So because they just get too excited because the pressure's off.

Speaker: 20:54
So I feel like we always end up getting in our own way when we begin overthinking.

Speaker 2: 20:58
Yep, absolutely.

Speaker: 20:59
The anxiety overs overs it feels like it's a tornado. And I've struggled with it a lot, just being able to stop myself and just being able to calm down and relax. And I think that's really important what you said, like taking sex off the table, but really going back to the basics. I think a lot of people think that sex just needs to be this high-level intensity thing where it doesn't need to start like that. And it doesn't go in that direction when you start to that kind of or have that kind of expectation out of your mind.

Speaker 2: 21:23
I mean, the amount of people who come in and think sex is supposed to last, like intercourse is supposed to last an hour. My response is always like, dude, like we all got other stuff to do here. Like, no, sex intercourse does not need to last an hour.

Speaker 1: 21:37
Sure.

Speaker 2: 21:38
Intimacy, though, because it starts outside of the bedroom and then it goes into the into the bedroom, like that is a that's an audio process. So, but sex itself, like that's this that's just the kind of like the the icing, right, on top of the cake. So exactly as it should be.

Speaker: 21:56
Right. And I and I completely agree with you. I think intimacy, what you said was important, it starts At all levels, beginning in the middle and during sex and then after. I never realized it. After is a huge, huge thing. And I think that a lot of people are gonna really connect with that. And it's really funny now that we're talking about like a like or how long orgasms take, but I think what people what a lot of couples want to know is the frequency of sex. Like, what is the normal frequency? I think we we get so focused on the number and like what number, how many times did we have this week? Or but I don't think it's about the number, right? What is the normal free? Is there is there a normal frequency? Should we get that even off the table? What is one more for you?

Speaker 2: 22:35
I personally don't like hearing when couples go a really long time. Like we're talking weeks, months without having sex, because that usually indicates a larger problem. And rarely is the couple like being completely honest with each other if they're going that long without having any kind of like intimacy. Barring, of course, if you have a couple that are both asexual, like that's a whole other different topic, and we won't really have time to really get into that today. So for some couples, once a week is very normal. For some couples, every day is very normal. For some couples, it's once every two weeks. Any longer than once every two weeks, I'd want to check in with them individually to make sure that they're good with that frequency. But normal is what's normal for you.

Speaker: 23:21
Yeah. So sex also means different things to different people, right? And so what one couple considers sex is different from how another couple might feel. And some may choose not to even have sex at all. But what if my partner is just not interested in sex?

Speaker 2: 23:36
Well, is it ever? Like if they're if they've never been interested in sex, then it may just been like a mismatched relationship from go. If they've recently or over time lost interest in sex, then we wanna figure out okay, what's the problem? Because the lack of sex isn't the problem. Again, it's just a symptom. It's why why are we not connecting? Where's that, where's the lost connection coming from? And you know, we all know life happens. Everybody, we have jobs, kids, other commitments, aging parents, our own health struggles that we might be going through, and all of that will play a part. But we want to make sure, okay, what is what's causing us to disconnect here? And if the sex drive drive was there to begin with, and now it's gone, there's definitely a miscommunication there. So we need to figure out what's going on there.

Speaker: 24:40
A lot of people look at porn as cheating, which causes massive disconnections, especially in the relationship. There's a new report that says that one to four men prefer choosing pornography over having sex with their partner, and one to three women are concerned about their partner's pornography viewing. What happens if my partner prefers porn over having sex with me?

Speaker 2: 25:01
So if your partner is preferring porn over sex, then we need to figure out the why. Because again, it's a symptom. There is ideally, I just get all of them in for individual sessions to figure out the figure out the why, but there's always going to be a reason why they're preferring porn. I know you you talked about like loneliness is a is a problem amongst a lot of men. That performance anxiety too is a big thing that comes up. Like porn masturbating to porn is a time when I don't have to perform. Yeah, I don't have to make sure that she climaxes. I don't have to I don't have to think about anyone else but me.

Speaker: 25:44
Right.

Speaker 2: 25:45
And so they can just it's it can be stress relieving, it can help with sleep, like all of those things. But at some point, if it takes on a life of its own, then we have to figure out the why, and then we have to come up with different solutions. Because again, we don't want one thing that they may deem as a good thing to help bring them relieve stress or go to sleep to hurt something else, which would be the relationship. So we always have to figure out the why. Figure out the why, and then and then we go from there.

Speaker: 26:18
Yeah, and I think we had the conversation before the podcast started, just a little bit guys jumping in about like how porn is affecting people. I and I think we came up to an agreement that porn is not the problem, but it's your own discipline and within yourself and having to accept like when is it becoming the problem?

Speaker 2: 26:35
Yeah, so when is porn a problem? Well, like I said, if it's a problem in the relationship, then it's a problem. But also if you are avoiding social events so that you can stay home and watch porn, if you are avoiding sex so that you can masturbate instead. If you're waiting for that time when your partner is in the shower to go and quickly watch porn, then there's a problem there. Yeah, yeah. So there are certain times where porn will become a big problem. And if you're feeling a lot of shame and guilt afterwards too, like why are we feeling those those emotions? Porn, like we agreed, it's in moderation. I I personally have no problem with porn. It's there to serve a purpose, but it can become just like anything else, it can become a problem. And so if it's interfering with your life, there's a problem.

Speaker: 27:29
Yeah, and the moderation thing is so important. Like, I think that it all plays a part in all of our lives, is trying to figure out what is moderate moderation for me. And the porn can really have a large effect on just like who you are, on your relationships, and like the like you said, like the continuous going back to it. So I kind of want to change, change it and move into a different direction about masturbation. That masturbation is normal. We know that it's healthy, we know that it helps sexual development. We'll make sure. We'll say that one more time for the community.

Speaker 2: 27:58
Masturbation is great, it's a great way to learn about your own body. How are you supposed to help your partner understand your body if you don't understand your body? So I I would love for everyone to come out and figure out what feels good for them.

Speaker: 28:19
Sure.

Speaker 2: 28:19
So that they can teach their partners.

Speaker: 28:22
How do I learn about my what I like without shame with my partner? I think that's can be a scary thing.

Speaker 2: 28:29
Without shame with your partner.

Speaker: 28:30
Yeah.

Speaker 2: 28:31
Oh, okay. This goes back to a a therapist will throw this term a lot, throw this term out a lot of senseate, sensei focus. And you can do it where you're just self-playing in front of your partner, which can be very difficult, especially if you're kind of someone who has body image struggles. Or you can do it with your partner. Sometimes it's like something fun to do in the dark under the sheets where you're fumbling around and stuff. Allowing them to try new things on you, you know, of course, you will want to make sure that everything's entered. And then you and then taking turns to do it to the your partner. Uh, there's a game that I always teach my couples as well. It's called the 15, 15 minute game. And it starts with I'd say to you, what would you like me to do to you for 15 minutes? And you can just throw something out there and and we'd go we'd negotiate the terms. Like let's say you said, I would like you to brush my hair for 15 minutes. And I could say, can would you like me to use this comb or would you like me to use this brush? How about if I run my fingers through your hair? How does that feel? And you know, we'd basically come to a negotiation agreement, and then for 15 minutes, I get to play with your hair. And then the second part, and then and then we flip it and you do it to me. And then we'd take it one step further, and I'd say, what would you like to do to me for 15 minutes? And then you can tell me what you'd like to do. We'd negotiate the terms, and then for 15 minutes, we get to explore that. And that's a really good way, again, to kind of bring it in, not necessarily fantasies, but working on bringing in what you need into the bedroom. You don't know, you don't know what you haven't tried. So yeah, it's a it's a it's a really good game to play.

Speaker: 30:26
Yeah, and I love these little tips that you're teaching couples, you know, and I think a lot of people are gonna take these and use them. And I think they're very important when it comes to trying new things and trying to reconnect, especially when it comes into the bedroom. I know that a lot of parents these days have a lot of struggles when it comes to just having children, and children can take so much of our time, right? Like, and and when we start scheduling sex, it does become important. But what happens if I'm a couple who's who has just had a child and now the issue has just become the intimacy? How do I reconnect with my partner after having a child?

Speaker 2: 30:57
Yeah, that's a tough one because not only like when you have a child, and I'm a mom of two, so you're dealing with the fact that you had lack of sleep for the last trimester, and then you're throwing a screaming newborn, and if you're nursing them, then you're leaking everywhere, your body doesn't look the way that you're used to it looking. So we're grieving the loss of our body, we're grieving the loss of our body autonomy because now we it's owned by this screaming infant. Yeah, literally. So there's a lot of I was I use the word grief. There's a lot of grief involved with becoming parents, there's a lot of joy as well, and I'm 14 years out from having a kid now, so it does come back. But there's there's a lot of time where we have to kind of just kind of go through that grieving process, allowing the body to recover, allowing you to your partner and yourself to just get used to how different everything looks. Obviously, we don't want to have sex prematurely, especially if you had any kind of surgery like with pregnancy and stuff. But when both partners are ready for their intimacy again, we go back to the the basics of let's start making sure that we're flirting with each other, let's start making time for each other, let's have that coffee when babies sit down for the nap and checking in on each other, making each other feel seen and heard. And that kind of leads into the intimacy again. If you have a partner who is just had a baby, making sure that they get rest. Sleep, sleep, sleep. Number one. If they're well rested, the sex drive will come back. If they're not, if they're tired, if they're stressed out, if they're depressed, then all of that is going to prolong things.

Speaker: 32:55
Hmm. I know I I never thought about it like that. You know, I think that's really important. Like rest does play such an impactful part of just our lives in general. And I could think that, yeah, your partner should feel fully rested. I think that would definitely make them want to just be in this, it would give them the normal level of chemical balance that they need, especially. And that will that'll force them just to have and want to have more desire with their partner. Now that we've talked a lot about kind of children, imagine if I mean you've had to have this conversation before, right? Educating your child about sex. When and how does I know the what is it, the birds and bees, or if I'm correct?

Speaker 2: 33:31
You know what? I I never actually know what the birds and bees story is. I grew up in an Asian household. We didn't we didn't exist below the neck until we were married.

Speaker 1: 33:40
Literally.

Speaker 2: 33:41
So it's I've never had anyone have the the talk with me. I can fully admit that I think I fluthered through it when I had the conversation with my kids. But the the biggest thing was just to just to start having, just to get over the initial hump, get over the initial awkwardness of letting them know, like, hey, as you get older, as your hormones kick in. And so we always say, kind of start the conversation. I don't say we always say, this is my own take. I wanted to have the conversation before the hormones, before puberty really set in, because that's when hormones go crazy. We start noticing people that we're attracted to. Our friends will start having boyfriends and girlfriends, even though I still think it's kind of young. I have a 14-year-old girl and a 17-year-old. 17-year-old boy, fine. 14-year-old girl, okay. Yeah, she's getting into it now. But having the conversation way before then, using the correct terms for the body. I have adults who come in and say that they didn't know that the vulva was called a vulva. They would call it a vagina. It's not. It's it's the vulva is the whole thing, the vagina is just just the whole. So using the correct terminology, making it just very part of language, you know, not making it a shameful word. Penis should never be a shameful word. It's it's just a penis, you know. So just bringing it into conversation and making sure that you have open communication for your kids, letting them know it's normal to have certain desires, it's normal to wake up with an erection. I think boys get it when they're babies. So yeah, letting them know that they can always come to you when they're curious or if they hear something in the schoolyard. Like I grew up with so many, so much misinformation. I think one of the ones I always remember was being in high school and they were talking about how to prevent pregnancies. And someone said, Oh, if you have unprotected sex, just make sure you go swimming afterwards because the chlorine will kill everything. You know how many people we had, how many pregnancies we had in our school? It didn't work. Yeah. But there's this just kind of like that misinformation you hear a lot. And I I want my kids to come to me with those questions, yeah, not ask their other friends.

Speaker: 36:07
Yeah.

Speaker 2: 36:07
I mean, fortunately now you have Google. Or unfortunately, now you have Chat GBT and other AI. So they can always find their answers. But I would prefer them coming to me because I would want to know where this information should come from. Does it make them curious? Is it making them ask other questions that they that they have?

Speaker: 36:28
Yeah, and misinformation can cause so many issues. People don't understand, like, I know as a therapist, you know, that with social media and everything, like people come in with misinformation, thinking that they're diagnosing themselves with different things, you know.

Speaker 2: 36:39
Love that. Love TikTok for that.

Speaker: 36:41
TikTok has truly driven a good run for having people to self-diagnose. And I think that's what causes a lot of difficulties. And I think what's scary also is like a kid trying to talk to their parent, right? Like, how do I talk to my parents about like me wanting to explore sex sexual things or if I'm having sexual desires? How do I come up to my parents and say, hey mom and dad, I've had these weird desires? Like as a kid, it could be scary, right? Did you ever have to go to your parents and want to talk to them about it? No.

Speaker 2: 37:10
So I I was fortunate. I had a lot of sisters. I have two older sisters and then a bunch of younger ones. So we were always kind of like openly talking about these things anyway. Although we were just spreading misinformation amongst each other. So do I wish I could have spoken to my parents about it? Yeah, it would have been nice. But I'm pretty sure my parents also had a lot of misinformation because they never spoke about it. So starting with my generation, I I want my kids to be able to just come to me and just just being curious. I I don't care if I'm eating breakfast and they come to me with a question about sex. Like, yeah, let's talk about it. This this can be a topic that we we talk about everything else at the dinner table. So why should there be shame about sex? How a kid can talk to their parents, that's a difficult one. Because you I need the kid to be in an environment where they feel like they can. It really starts parents, the parents making sure that the kid, their kids know that they can come to them with anything.

Speaker: 38:15
Yeah, and stable open communication with your parents and having to address that with your child and being like, if you do want to talk to me about this like that, the the doors are open. This isn't something like a closed door kind of conversation. And I think that just goes back to parenting, like in the beginning, like how do I have an open communication with my child? And now that we're kind of going in this direction, I kind of want to know at what point should someone or a couple consider seeing a sex therapist? When should they come to you and get the help that they need? When in the relationship have they realized it's failing, we need to figure this out, or this is not gonna work.

Speaker 2: 38:46
I mean, the moment you have the the thought of this is failing, we're a little bit like we're we're in the thick of it by then. So they should definitely make the call then. But if you are in a relationship where you feel like you've tried to communicate and it's not working, then that's usually the time to to bring it up, bring up talking to a therapist about it. And some couples they really just struggle hearing each other. And even if we I'm gonna backtrack for a second, because some people will say some people will assume that sex is the problem. And again, it goes back to it, it's not, it's communication. And so when they're seeing a therapist, a sex therapist as well, and I'm talking to them continuously about communication, communication, and they're thinking, Well, our issues isn't communication, our issues is the fact that we're not having sex, it's it's not, it's because we're not communicating that. When if we can't communicate what we want and what we need, then it's good to to consider bringing in an outside help.

Speaker: 39:49
Yeah, I think outside help really brings a different perspective. I think a lot of people are scared and they're afraid to admit that they're failing in their sex life. And I think there's a point of like realization that you have to get past and just accept, and the pride will come in the way and other things. But I think what I want people to address and understand is that there's no issue with getting help that you need, and it's going to help you and it's going to get you into a better place. And what what if I told you a couple of sessions will get you back to back into a relationship where you guys are having sex again? I think that's what you need to be looking at instead of the the scary feeling of I need to go talk to a sex therapist. Oh my god, how am I going to address this with my partner? Um, and just having the open conversation, like you said, communication. We've come down to the last question, and I think that this is an important one. What's one message you want people to take away from this to building a healthier sex life?

Speaker 2: 40:40
I mean, besides communication?

Speaker: 40:42
Yeah, we need to put communication away for a second.

Speaker 2: 40:45
All sex is normal. Your sexual desires are normal, your body is normal, your wants and needs are valid. Sex the thing that I want everyone to know is that sex, it it should never be a taboo. It shouldn't be something that we deal with by ourselves, that we struggle through by ourselves. It should be something that we just have always talked about. It's the thing that brings us closest to our partners. And that needs it needs its own time and space. It needs its attention. And so let's let's work on continuing to normalize all of this stuff.

Speaker 1: 41:28
Yeah.

Speaker 2: 41:29
So that so that I don't have a job in the future. Because if I if if everyone is having sex, I'm happy. Like that's great. Because other things fall into place too.

Speaker: 41:39
I completely agree with you on that. I just want to say thank you for coming onto the podcast. I really appreciate you having this open conversation with us and communicating with us. Because I know that's that's a really big word in this podcast. But I want to remind people it's okay to ask questions, it's okay to not have it all figured out. And in in the end, it's more than okay to seek help. If any of this resonated with you, please take a moment to share it with anybody. I know that it can be kind of weird to share this with your partner and be like, hey, listen to this podcast episode about sex therapy with a sex therapist, you know, like, but just take the moment to reflect and get a better understanding of what you're struggling with. And I just always want to remind you, please, please, please remember you are not alone, and we're excited to catch you on the next episode. Bye.

Speaker: 00:03
YNA is a podcast that focuses on mental health and other aspects relating to what goes on inside a person's head. We are by no means professionals in this field and only aim to make these conversations about mental health easier for the listeners. Nothing we say or talk about is professional advice unless explicitly mentioned. If you seek professional advice or experience symptoms of an actual mental health disorder, please contact a professional or visit your closest center for behavioral health. You are not alone.

Speaker 2: 00:30
Hello, hello, hello. Welcome back to You Are Not Alone episode on Bipolar Disorder. I'm joined here with Dr. Nelson, who is going to explain more because I don't have enough information myself on bipolar disorder. So someone who does have maybe has it or is going through something like this, hopefully we can shed some light on more information for you to help you out.

unknown: 00:56 Dr.

Speaker 2: 00:56
Nelson, do you want to talk to us about your credentials first to tell everybody what you do?

Speaker 1: 01:01
Sure. I'm a counselor educator and have a private practice. Um I have a doctorate in counselor education and supervision and have been in private practice serving our community in Rockford and Lake in the Hills now since like 2011. Oh wow.

Speaker 2: 01:17
So you've been in this kind of industry for a very long time. Yes. So you have you experienced clients with bipolar disorder? Yes. Okay. Could you explain to us what is bipolar disorder?

Speaker 1: 01:28
Sure. One of the easiest ways to explain bipolar disorder is that which goes up must come down. And so if something goes too high, it's probably going to correspondingly go too low. And that's the problem with bipolar disorder. So uh it's characterized by what's called a manic episode, and that is an elevated mood, and it's it's noticeably elevated. So it's not just somebody is feeling good today. Friends and family oftentimes will point out the symptoms that something's different. That mood is drastically different.

Speaker 2: 02:01
Is it because of the emotions that you're going through that you feel these really high highs and very low lows, or is it just a part of the disorder that makes you feel like you have to that you're just pushing through this high and lows?

Speaker 1: 02:17
It's it's more of a brain chemistry issue than an emotional issue, although I think sometimes it can be triggered by different things like that have an emotional impact. However, it's more of an organic kind of uh chemical imbalance in the brain that causes the elevated mood and then oftentimes a corresponding crashing mood. Do you know what an episode would look like if someone has bipolar? Yes. Now it's going to depend. There's there's two basic types of bipolar, bipolar one and bipolar two, but the symptoms are going to be similar. So someone that has uh a manic episode, and I should point out that it only takes one manic episode, one true manic episode to be diagnosed as bipolar, although the episodes can reoccur and sometimes can reoccur quite frequently, but it only takes one for a diagnosis. So typically what a client would present with is they feel very up high, elated, or irritable or grouchy. So again, this is unusually high, kind of like you might imagine someone on a stimulant like cocaine or methamphetavine. It's like noticeable. They can feel jumpy or wired, they can have a decreased need for sleep. Sometimes they won't sleep for days and yet they don't feel fatigued. They can have a loss of appetite. Sometimes they'll talk very fast about a lot of different things. They can feel like their thoughts are racing. They oftentimes feel like they can do a lot of things at once. And one of the more significant symptoms is they oftentimes do risky things or show poor judgment. So they'll make rash, kind of impulsive decisions, sometimes really big ones like blowing through their retirement in Vegas in one weekend. So they can do other things like uh thrill-seeking kind of behaviors, uh, dangerous, like unprotected sex kinds of things. And uh another symptom is grandiosity, and that's where they feel like they are unusually important, talented, or powerful. So again, it's similar to what someone might experience when they are having, uh let's say using cocaine or methamphetamine. I mean, that's kind of what the symptoms can look like.

Speaker 2: 04:25
Now, is doesn't seem like bipolar is very common in a lot of people these days. However, if I was going through bipolar disorder and maybe I'm just not taking the symptoms and my friends are not seeing enough, is it really easy to tell if someone's going if going through bipolar disorder, or does it take time and like like you said, it took one episode for you to really feel? But could you have parts of episodes? Like if I feel very adrenaline thrilling seeking and I want to go do something thrilling and then I go and blow my whole savings at one point. Now, that is a small is one of the symptoms, but that that's not all of the symptoms together. So, how do I figure out if I do really do have this disorder?

Speaker 1: 05:13
Well, we we try to clarify that you've had several of the uh manic episode symptoms. Now, I probably should clarify too, bipolar two is similar to bipolar one. Bipolar one is the more extreme version. Bipolar two has hypomanic episodes, and those are similar, but they're not quite as grandiose as intense or as a full-blown manic episode, but the symptoms are similar.

Speaker 2: 05:38
Do you see a common resemblance? I mean, as the symptoms with bipolar one and bipolar two, but is there any more of a difference so that I could understand if I do maybe have bipolar one or bipolar two?

Speaker 1: 05:50
It's it's a little bit challenging, uh particularly without sitting down and going through some of the diagnostic criteria, but the the hypomanic episodes that are associated with bipolar two, basically a person feels good or able to get things done and they can keep up with day-to-day life. So it's harder to diagnose bipolar two than bipolar one. They might not feel with bipolar two that anything's wrong. However, again, family and friends are likely to recognize the changes and point them out and express concern with uh bipolar two and hypomanic episodes, if they're not treated, the person can develop more severe mania or depression. So that's really the issue, too, is that people will oftentimes present, let's say, to their primary care physician with depression. But if the if the physician or the mental health professional, like in our case, does not screen for the manic episode, that can be tricky too, because if someone's bipolar and they're put on an antidepressant, that can actually cause a manic episode.

Speaker 2: 06:49
Okay, so the medication could give you a realization of maybe I do have this disorder if I go through a manic episode, if I were to get some sort of medication from depression or anything like that.

Speaker 1: 07:01
Well, that's a good point, Cena, too, because with bipolar disorder one and two, the best practices for treatment are going to be medication number one and then combined with counseling to manage some of the other things that go along with it. But the medication will temper the moods uh so that they don't spike as high and they don't go too low. But the problem is if someone goes and is diagnosed with depression and it's actually bipolar disorder, the medication for depression can actually trigger the symptoms and make them greater. So with um bipolar one and two, it's usually a mood stabilizer that the person would be put on in terms of a medication as opposed to depression, is typically going to be a selective serotonin reuptake inhibitor that kind of helps our brain to get the feel-good chemicals to build back up.

Speaker 2: 07:48
Now, let's say I'm a friend and I have a friend who could have symptoms of bipolar disorder. Is there any signs? Because, like I have a lot of friends, I would have to say, that do crazy things and do thrilly-seeking adventures and maybe not communicate with me well enough. But how do I, how do I, as someone who has a friend that goes through bipolar disorder, how do I see that, hey, that episode is kind of this person's acting different or maybe not the same as they were? Like, is there anything I should look out for?

Speaker 1: 08:21
Probably uh, I'd say trust your gut. And so you know your friends. And if you see behaviors that are alarming, that's what we'd really look for. So, especially um adolescents and emerging adults, you know, uh the late teens and up through the 20s, that's characterized by kind of more uh thrill-seeking behaviors. That's part of adolescence, which now actually goes up through about age 28. So just some impulsive decisions could just mean that someone is uh an adolescent still. But when it gets to be extreme where you are alarmed, that's where we need to probably consult with a mental health professional to find out if your friend actually does have bipolar disorder or not.

Speaker 2: 09:07
Now, if I could give any recommendations to friends who may be going through some symptoms that don't may not have the money to go see a counselor or just don't have the uh necessary power to go and do and get the diagnosis. Do you have any recommendations to help people like maybe calm down, deep breaths, relaxing, anything?

Speaker 1: 09:29
Well, there's there's a number of things that people can do. Um uh deep diaphragmic breathing. Um, one of the best thought stopping techniques that I know, I call it sevens, is you pick a large number at random, like 832, and count backwards by sevens. It's really hard to, for example, worry or uh uh project into the future or anything when you're counting backwards by sevens. But with bipolar one in particular, it's uh it's really gonna require medication. So the person really does need to see their physician and uh be assessed to make sure that they are properly diagnosed and treated. Otherwise, the symptoms with bipolar one are not probably gonna be manageable by themselves using other means like coping skills and strategies.

Speaker 2: 10:12
So this whole thing sounds extremely terrifying. I mean, if I was somebody sitting here listening to this and I'm listening to the way that you're describing the symptoms and I'm and you know, you go into that process of self-diagnosis, where which a lot of people do, and they try to start telling themselves I have these things. However, um, is it normal to have bipolar? I mean, it's it is normal to have it, but can I live a normal life with bipolar disorder?

Speaker 1: 10:37
Absolutely. If properly treated, specifically bipolar one, again, is going to require medication, as is bipolar two, but bipolar two symptoms tend to be more manageable. But if it's not treated with medication, then bipolar two can turn into bipolar one, the more extreme version. So with medication and again, ideally combined with counseling, uh, people can live a normal, satisfying, fulfilling life without the uh impulsive decision making that can be actually very damaging, like financially, physically, uh, in different ways. So definitely bipolar disorder is manageable with medication and ideally combined with counseling. Do you how does bipolar two become bipolar one if if that manic episodes do continue? It doesn't always, but it can. So if it's if it's not treated, the brain chemistry can continue to change and it can turn into the more severe bipolar one. So if you're in doubt of whether you have bipolar one or bipolar two, then it's it's best to seek help and get properly assessed and rule it out or determine that you have it so it can be properly treated. Okay, wow.

Speaker 2: 11:46
And I'm just trying to understand this as something that people do have. Um, how do I talk to a friend who has bipolar one or bipolar two and they're diagnosed with it and they do take their medication? However, they feel as if um having a conversation becomes difficult, or how do I keep that normal friendship going? Because it is a scary disorder that something that people do go through and you lose friends and you lose people. But if someone wants to stick by your side to make sure you're okay and like keep that friendship alive, because it is it is scary when you do have a disorder, because it feels like a lot of people are looking at you like you're this animal, you're this monster who has this kind of thing wrong with them, when it's perfectly okay and normal for people who do have that kind of disorder to react to the situations they do.

Speaker 1: 12:37
Yeah, you know, the big thing is to be a friend, be there, be supportive. But again, if your friend is not compliant with medical advice, like they're not taking their medication, the symptoms are probably going to be more extreme. And that's where people can lose their jobs or lose friends or lose family because of the radical mood shifts and swings. And sometimes it's just euphoric, other times it can be really irritable, angry, um, those kinds of things. And that's not good for relationships. But um the stigma that goes along with mental health is slowly going away, uh, especially when people understand that almost all of the mental health disorders are very treatable and there's there's prescribed best practices. And what that means is that things that have been shown by the research to be effective with certain disorders and with bipolar disorders is going to be medication number one, ideally combined with counseling.

Speaker 2: 13:28
So if we're taking a step back away from um bipolar disorder and just looking at mental health and trying to understand how important it is, could you describe, after all of your years of experience, how important really it is to seek maybe help or to cry out for help or find a way to receive the kind of help that you can get for yourself? So because I feel as if there's a lot of people who lose a lot of friendships and lose a lot of things, and there's a lot of people who don't understand people that people with disorders and with mental health, they do need help and they do need someone to talk to that they're not these monsters that we try to make them seem like.

Speaker 1: 14:06
Yeah, the the big thing with mental health conditions is usually the sooner that they're diagnosed and treated, the better. So the longer I let something go, typically the worse it can get. And um one of the things that mental health professionals look at is moods that are too high or too low. But there are there are other issues that people struggle with. Good news is very diagnosable, very treatable, whether it's post-traumatic stress disorder, bipolar disorder, depression, anxiety, panic. Uh, there's there's treatments that are available to help people return to, like in psychobabble terms, we call it return to a previous level of function. So like get their life back and get back on track with things. Sometimes I explain things to people, like sometimes just life kicks us once too many times in the solar plexus, and we kind of go down on the mat and we can develop some mental health conditions, but with proper treatment and coping skills and strategies and talking to somebody, um, almost everybody can recover from pretty much anything. But the sooner that they seek treatment, the better. It's it's a good idea to kind of call the fire department when there's first smoke in your house versus waiting until half the house is burning. So the sooner somebody seeks treatment, the the better.

Speaker 2: 15:22
As we come to an end and we wrap everything up, um, trying to explain to people how information and being able to discuss things that are very hard to discuss. Do you recommend one last thing to someone who feels scared and alone and doesn't feel like they can be able to discuss something like this? Do you have any recommendation to help them?

Speaker 1: 15:47
Yeah, you know, it's a good idea to find a competent mental health professional. And there's places where you can look and read people's bios and profiles like Psychology Today has a uh a large set of providers that you can kind of look at them and see who you kind of click with. But one of the things that, because I'm a um counselor educator, so I train other mental health professionals, and I constantly am telling them remember that we have the privilege of helping people get their lives back and live their lives to the fullest. And that's a huge responsibility, but it's kind of a sacred trust too. So we basically wade into people's souls and psyches and help them sort things out. And um, sometimes people tell us stuff that no other human being knows, and that's kind of a sacred trust. So, mental health professionals were bound by our ethical codes to uh confidentiality. So that's one of the nice things is we're unbiased, and people can kind of come in and they can talk through whatever they need to. And then unless there's a safety issue concern, like they're gonna do harm to self or others, then they can expect confidentiality during those sessions. And so it's really um therapeutic sometimes just to get stuff out there in that kind of a context. There's a saying in the 12-step communities that we're only as sick as our secrets. And the idea there is that when we have secrets, we carry them. There's a burden that goes along with them. So a lot of people feel better just by getting those burdens unloaded and getting the secrets out in the open with a therapist. And uh then we can apply best practices to deal with whatever issues might be involved with that.

Speaker 2: 17:27
Okay, thank you so much for talking with us. Thank you for all the information. If you're out there and you are feeling some sort of way and you need help or you just need someone to talk to, I'm glad I can share enough information for you. And I do want to let you know please, please, please always remember you are not alone in this fight. You got this, we've got your back, we're gonna get through this. Thank you again.

Speaker: 00:03
YNA is a podcast that focuses on mental health and other aspects relating to what goes on inside a person's head. We are by no means professionals in this field and only aim to make these conversations about mental health easier for the listeners. Nothing we say or talk about is professional advice unless explicitly mentioned. If you seek professional advice or experience symptoms of an actual mental health disorder, please contact a professional or visit your closest center for behavioral health. You are not alone.

Speaker 2: 00:30
Welcome back to You Are Not Alone. We are here with Dr. Nelson. We this episode is on depression. So before we get started, Dr. Nelson, if you'd give us your credentials, just tell us a little bit about how long you've been in the industry and your experience.

Speaker 1: 00:48
Sure. I am a counselor educator and supervisor. So I have a doctorate in counselor education and supervision. I train mental health professionals academically, and then I also coach and mentor them. And I have a private practice with two office locations in Rockford and also in Lake in the Hills, Illinois. I've been a people helper for about 20 years, but in private practice since about 2011.

Speaker 2: 01:12
So this one kind of hits home for me. This episode is extremely important. I really wanted to not just be able to speak about it, but be able to have all of the information to make sure that the people who are feeling depressed are able to get that the help that they need. So we can just start it off with what is depression?

Speaker 1: 01:33
Depression is not how a lot of times people talk about it, like, hey, I'm depressed because the weather's rainy today, that kind of a thing. Depression is a mood, but it's unusually, it's remarkably low. And so it's not just what pop culture kind of calls depression. Um, it's characterized one of the big things that we look for is a sense of hopelessness. And so it feels kind of like a rut that somebody gets into, and then we feel trapped and like there's no way out. So it's a it's a deep, dark, depressed mood.

Speaker 2: 02:05
And it seems like what I've heard and how to understand this is like one of the disorders that many people struggle with. And it's something that a lot of people don't seem to be able to get a grasp onto, or they can't find the difference between what is being sad and what is being depressed like. And especially for people who do go with it and have friends who don't have depression. And if a friend does reach out and say that they're depressed, that they don't know understand how to talk to somebody who maybe they're just not feeling the way that they should be.

Speaker 1: 02:45
And that's characterized by an unusually low mood. But how we define it in mental health circles is failure to fulfill major role obligations. So that means like I'm I'm not doing schoolwork, so I'm in danger of getting kicked out of school, or I'm I'm too depressed to get up and get out of bed, so I might lose my job, or it affects my family relationships. So it affects my ability to function on a day-to-day basis. It's not just a normal I feel kind of down because of circumstances or something. This is deeper than that. And the symptoms are pretty much most of the day, nearly every day.

Speaker 2: 03:24
Okay. And so if someone is feeling depressed, what are some things that they do go through in their everyday lives?

Speaker 1: 03:32
They can feel sad, tearful, empty, and primarily hopeless. That's one of the things that we really look for as a diagnostic symptom. They can also, which is kind of interesting, be irritable, angry, frustrated. They tend to have a loss of interest in pleasurable activities. So that could include uh things they do for fun, hobbies, sports, uh, including sex. It can affect their ability to sleep. So either they sleep too much or not enough. Typically they're going to be tired and have a lack of energy so that even small things seem overwhelming. And the way that I describe that to clients sometimes is it's it's like you're trying to get through life and you're waiting through like molasses, this thick, syrupy stuff, and trying to move forward. So even small things become overwhelming, can have a reduced appetite and weight loss, or the opposite, increased cravings and food and uh corresponding weight gain. So, in essence, I binge kind of or I uh restrict my eating. I can also, which is another interesting symptom, experience anxiety, agitation, or restlessness. So depression can have anxiety kind of symptoms that go along with it. I might be uh find it difficult to think. I might slow down in terms of my speech, my body moments, my uh thinking. And a bigger one is feelings of worthlessness or guilt. Now, typically, too, what clients will do is they'll fixate on past failures and start to blame themselves. So there's actually a corresponding characteristic of people that are depressed tend to be very self-critical and self-blaming. They can have trouble thinking, concentrating, making decisions, and or remembering things. And they might have recurring thoughts about death, suicidal thoughts, suicidal attempts, or suicide itself. And lastly, they can have unexplained physical symptoms that like uh somatic symptoms like back pain, headaches, those kinds of things. But these symptoms are not just the dips that everybody experiences, these are where the mood goes way too low and it kind of stays there and it makes it hard for people to function in life.

Speaker 2: 05:49
So, would you say that's the difference between the biggest question of I'm feeling sad one day and I'm feeling depressed?

Speaker 1: 05:56
Yes. It's it's a degree of severity and longevity. So the when someone is depressed, they typically don't get better without counseling andor medication. And it's when they are not functioning in life, like at home, at work, at school, they're just not able to keep up. They they have difficulty getting out of bed or doing things that used to be easy. And so that's when we really want people to seek help from a qualified mental health professional andor their medical professionals.

Speaker 2: 06:27
I believe the hardest thing with depression really is um having other people understand what depression is like or understanding if someone is depressed. How do I, as somebody that if I didn't have depression and I was speaking to a friend who did have depression, how do I tell whether they are feeling depressed or not? Or how do I even speak to them without making them maybe even feel more depressed?

Speaker 1: 06:55
Well, that's a good question. Because even when someone might have suicidal ideation, let me just address that for a second. Ideation is psychobabble for I have thoughts about self-harm, like suicide. Um, that as a mental health professional isn't alarming in and of itself because most people at one point or another in life, if life just hits them again one too many times, they can feel down or like it's it's painful. I don't want to do this anymore. That doesn't mean that I'm actually a risk to myself. It just means that life kind of sucks right now and I don't want to deal with it. Intent is a whole nother issue. So when we screen someone for suicide risk, we look at ideation, that's the thoughts. In and of itself, that's not that big of a deal. And most people experience that at one point or another. Intent is I intend to not be here, I intend to kill myself. That's a whole nother level. And that's kind of a red alert kind of a thing. When someone has intent, we need to make sure that they're safe. But then we also look for things like do they have a plan? Do they have means? So there's a whole process that we use to screen for that. But um, suicidal ideation by itself isn't that big of a deal. It's when the mood gets way too down, people have a sense of helplessness and hopelessness, like I can't get out of this. There's nothing I can do to make things better. And that really, I'm gonna kind of classify that as a delusion, but it feels real to the person at that time. And typically, from what I've seen in the research, it has to do with uh low serotonin levels. And so one of the medications that uh a physician can prescribe is called a selective serotonin reuptake inhibitor. It has minimal side effects, it's not habit forming, it's not dangerous, but basically it functions like a cork or a plug in the bathtub. When you when you put the stopper in, the bathtub level, the water raises up. And that's what the serotonin reuptake inhibitor does, is it plugs that part so that the serotonin stays in the brain longer, and that can really help people to get, I call it get their oomph back. And combined with counseling, that's a very effective method of treating depression. But depression is the mood is too low and it's affecting someone's ability to function in life.

Speaker 2: 09:05
With the ideation of if someone did explain to you that they did want to kill themselves, and there it because there is a separation between the ideation of someone actually plan on doing it and having the forces to do it, then someone who just keeps saying that they're gonna do it and it's not doesn't, they just keep reiterating things that don't really are are not really a plan. How do I, as a friend, if my friend does say he wants to kill himself, how do I speak to him or how do I tell that, hey, this is a plan of action, this is gonna happen, this is gonna happen if I don't stop him, or this is just him just going through a bad day and just got punched too many times?

Speaker 1: 09:46
One of the things that sometimes loved ones' family members, friends are reluctant to talk about it with the person for fear of maybe putting them over the edge or making it worse. But what we find is that it's okay to address it. In fact, some mental health professionals, when it comes to suicide risk assessment, they're a little shy to do that because it's it can be scary for novice counselors, for new counselors, family members too, it can be scary for them to address or loved ones. So one of the big things is to talk to that person, express your concerns, listen to what they have to say, and um hopefully read between the lines a little bit and tease out where they're really at. Because if they are higher risk, that's a big deal. And we need to assure that they're gonna be safe. So then that would usually involve like uh talking to family members, um, maybe even taking them to the hospital if it seems like uh they're higher risk. One of the things maybe the family or friends or loved ones could do is kind of trust your gut. If something creeps you out deep down, you're like, ah, something's just not right. I'm worried. That probably is a good indicator that you need to take some action to help your friend or family member get some help.

Speaker 2: 10:58
I've I've been into the position where I have been telling myself in a situation where I've had a depressive episode. It's I feel as if it's very difficult to sometimes talk about the things just because they're so heavy on me and the ideas and the feelings also, I feel like if I do explain them to somebody else that maybe I am hurting them in the process, how would you respond to somebody who is feeling something like that and is having a hard time opening up and talking about what they want to talk about?

Speaker 1: 11:31
That's actually a great question. There's a uh I'm gonna answer it with a proverb that used to uh be in my mom's bathroom of all places. Um, but it says, uh, a shared burden is half a burden and a shared joy is double joy. So sometimes what happens is when we get into uh a depressed state is we don't want to be a burden, and that can actually increase my risk. But uh the thing is, uh a shared burden is half a burden. And one of the things that I do is a tool that I like is called the flip reality test. And so what I do is I imagine a friend or loved one in the exact same circumstance, and I ask myself, what would I think or tell my friend? So if I'm depressed and I don't want to be a burden to anybody, so I'm keeping it in, I'm actually making the symptoms worse, not better. But if it was my friend that was depressed, I'd probably say, Hey, you know, help me understand, tell me about it. I want to be there for you. Well, I need to turn that around on myself and take my own advice. And there's a there's that's the delusional component to depression where um I feel like nobody can handle it. I don't want to be a burden to my friends or family. But if I care about them, I would want them to tell me. So they would probably want me to tell them. In essence, it's kind of a balancing thing too. Most of us are more self-critical of ourselves than we would be a friend. And we need to treat ourselves with the same care and love and concern that we would a friend.

Speaker 2: 12:57
That's the hardest is treating yourself with the love and care that you do with your friends because speaking those kind of words and giving yourself positive recommendations, I believe, is what I found to be really helpful in the um episodes that I've ever had. It's it's just it feels sometimes like I've been punched way too hard and I'm on the ground, and I just feel like I'm keep getting punched. How do I punch back?

Speaker 1: 13:23
Social support, probably number one. So uh they did a study years and years ago, and I never forgot once I read that one, where they had people stand in buckets of ice water, and I don't remember the exact numbers, but I think the average person could last about three minutes and they jump out. When they did it in pairs, they went six minutes. So, what's significant about that is uh social support is vital for us to do better in life. And so I need to have friends and family, and that's actually a protective factor for depression and anxiety is connection with other people, which goes back to a shared burden is half a burden. So most people feel better when they talk through something, even if they don't get great advice or something like that. It's just more like getting it out there talking through it can help. But when someone's deeply depressed, we probably need to get a medication on board to get the serotonin levels back up, and then they can snap out of it and get the help they need. So for severe depression, usually medication is going to be best practice combined with counseling. But for many people, for depression and anxiety, counseling by itself is quite effective without medication. But when someone can't function, they're having difficulty just doing the daily things that they need to do and that they used to be able to do, that's usually when we recommend a medication assessment.

Speaker 2: 14:42
Do depression and anxiety play hand in hand with how people react and emotionally in situations? I feel as if sometimes the depression can come in, but then the anxiety comes right behind it and smacks even harder. Um, so does it actually play hand in hand with other disorders as well? Or does it just try to play by itself?

Speaker 1: 15:05
Another good question. Uh, anxiety and depression can actually be like uh hand in glove or your fingers crossed, kind of like uh like twins almost. And so, for example, I could be depressed and then I'm not doing the things that I need to do. I might be not going to work, I might not be paying my bills, then I could get into financial trouble. Now I'm getting anxious. So, in that scenario, the depression leads to like not taking action on doing the things that I need to do, and then bad things happen. So suddenly I become anxious. Similarly, if I'm anxious, then um I can avoid things that need to be done, and high levels of anxiety are not sustainable. And so what can happen is I can just kind of crash into a depression. So they can ping pong back and forth, and that's another reason why I'm a fan of the selective serotonin reuptake inhibitors. Again, non-habit forming, uh, they have fairly minimal side effects for most people, and they treat both anxiety and depression. So it kind of knocks both out. Not everybody needs medication. Uh, again, it's going to go back to are they able to function and how severe the uh the lack of function is. But uh selective serotonin or reuptake inhibitors combined with counseling are very effective for both anxiety and depression.

Speaker 2: 16:28
If I'm I think what people are trying to get a hold of is that crawl, that boundary or that line that we have set. It's where you you pass it and you're like, I'm deeply depressed compared to just being depressed. What is that boundary? Is it many days of me not wanting to wake up, or is it many feelings of different symptoms? Or how do I know that I'm actually deeply depressed and just actually just depressed?

Speaker 1: 16:56
It's going to be when life is getting becoming unmanageable. So failure tick to technically in the psychobabel language, it's failure to fulfill major role obligations. So I'm I'm not working like I used to, I'm not going to school like I used to. My family relationships are falling apart. Life is just not working. And it's just because I'm too down, everything is a chore, and everything that used to be pretty normal and fairly easy to do is now a burden. So it's really where life becomes unmanageable. That's going to be the symptom that you're going to look for for major depressive disorder. Now, again, normal ups and downs are a whole different thing. Sometimes there's uh seasonal changes or the economy or whatever else can get to me and I can feel kind of down, but I'm functioning, I'm getting through life, I'm doing what I need to do. The difference from a mental health perspective for depression is I'm not. I'm not getting through life, I'm not doing what I need to do. And that's when we need to someone to seek help from a qualified mental health professional and/or medical professional.

Speaker 2: 18:05
Holland does, I mean, depression, I feel as if never goes away and it doesn't ever just completely disappear one day, and you're just like, I'm now cured from depression. But I think that with depression, you do it comes in waves, and and you can not control the amount of like how hard the punch is, but how how you can it control your emotions? And so, do you believe that depression can just simply go away, or does it or can I subside it and could continue my life and it can just come back in episodes?

Speaker 1: 18:45
That's that's kind of an intriguing question. I I would have to say it kind of depends. So, on the one hand, sometimes people actually just get better with time, but it's if life is challenging, not so much. It makes it harder. So some of it is uh nature and some of it's nurture. So there's can be a biological predisposition to anxiety andor depression, but then there's life, there's circumstances, there's uh economies, there's breakups, there's all kinds of different things that can kind of kick someone in the solar plexus and have them go down on the mat. But one of the intriguing things about depression that I've found over the years is that more often than not, it's actually repressed emotion. So I have a saying that if we self-deny, repress, or ignore our feelings, it comes out in anxiety, depression, and or compulsion. So when I help somebody to be able to identify their feelings, their emotions, and talk about them and work through them, lo and behold, anxiety and depression get better. In extreme cases, though, then we need a medication on board just because it's uh it's been going on too long to where the serotonin is depleted in the brain. But uh depression is very manageable. It does tend to come in waves and different levels of severity based on circumstances and how I'm dealing with it. There was a guy that was an ancient Greek guy called Epictetus, and he said something very profound back in ancient Greece. He said, people are not upset by things, but the view they take of them. So one of my sayings is sometimes life is just hard, but I can make it a lot harder, almost infinitely harder, by what I tell myself about it and how I view it. So it's important that I kind of have my head screwed on straight. And that's where I go back to the flip reality test. So I need to be talking sense to myself like I would a friend. So I always use that day in, day out. What would I think or tell a friend in the same circumstance? Then I swing it around on myself and I tell myself that. That helps me make sure that I'm seeing things accurately and my perspective is in the ballpark of, you know, where it is, where it needs to be. And that helps me to navigate things without falling into a deep depression. But if I am super self-critical and I keep telling myself I'm doomed, I'm hopeless, that kind of a stuff, then that's going to make it infinitely worse. And then that can help to precipitate a major depressive episode.

Speaker 2: 21:08
So affirmations are extremely important, clearly, especially on how you speak to yourself, because how you speak to yourself uh plays right back to how you're gonna feel. Are there any other types of things I could do when if if I'm wake up and I just feel at my worst and the positive affirmations are not helping? Because I know people get help from different ways and they get better in different ways. Do you have any other recommendations that maybe not medication, not counseling, and not the affirmations, but anything else that could help people that uh have depression and are getting their butt kicked?

Speaker 1: 21:46
Sure. It's best practices is increase the frequency of pleasurable activities. The problem is when I'm depressed, I don't want to do anything. Uh, even if it was something that was fun, like a hobby, a sport, uh playing video games, whatever it is. I don't want to do it. But if I can get moving, if I can get going, uh, and one of the easier ways to do that is leverage leverage social support. So like call somebody, tell them I'm having a hard time, help them to help me to get out and get moving, and or take care of stuff. Like sometimes I just need to chip away at things like pay my bills, or you know, if I got behind on my bills, go ahead and write those checks, pay them, uh, or whatever else I need to do to make life better. The flip helps me to determine that as well. Because I would tell my friend, you need to do this, you need to not do that. If I take my own advice, lo and behold, life tends to get better. Social support, increasing the frequency of pleasurable activities. Um, interestingly enough, too, one of uh the things that we do in our practices called EMDR, eye movement desensitization, reprocessing. There are EMDR-based techniques that can actually change the way neurons fire in the brain and can help take an affirmation or more accurate statement of truth and really make neurons fire around it to help me to kind of experience it rather than just tell myself something. So it's kind of like cognitive behavioral therapy and on steroids, in a sense, it helps my neurons to fire around those more accurate, adaptive ways of thinking and viewing things. So uh EMDR can also be helpful.

Speaker 2: 23:19
And so the last question to wrap it up. Again, mental health is a stigma. We don't really like to talk about things, we don't really like to explain how we feel. And a lot of the times um there's been people in your life that you've explained something to and they just looked at you and didn't really understand or didn't really try to help either. But could you explain to somebody who has depression that this is normal, that people do go through this, that it's okay to be feeling the way you're feeling, that things do get better.

Speaker 1: 23:50
Absolutely. I I can't tell you how many clients that I've had were actively suicidal. I don't mean they just they had ideation. I mean that they had attempted or they were high risk. And with counseling andor medication or the combination thereof, uh, they get their lives back. And I can't tell you how many people have come back and said I was hopeless. I didn't believe that it would work, the counseling that is. I didn't think anything would work. And um you you helped me to keep going. And by normalizing things and dealing with the things that I needed to, I got my life back. And now they're very happy that they didn't do anything unwise or foolish, like hurt themselves. Now, from a counseling perspective, that's stressful for us as mental health professionals because we care about our clients and and we have to walk uh a fine line there to assure for safety and then also to help people to learn and to grow. So, yes, depression, major depressive disorder is very treatable with counseling andor medication or both. And I cannot tell you how many people have gotten their lives back. And that's one of the reasons why I really love doing what I'm doing.

Speaker 2: 25:05
That's a great way to end this, is just to tell anybody who's ever felt the weight that you're feeling and you're depressed, sad, not just not you, that it's okay. There's people out there who have come back, who have clearly shown that they can fight this. And there's people that will fight this, and you are one of the people that can fight this. If you're listening to this and you're dealing with these kind of emotions, you can fight this, you can get through this. Please, please, please, please always remember you are not alone in this fight. I'm gonna help you get through it, figure it out. I hope you have a great rest of your day, and thank you for listening.