Mental Health Matters 🧠 Ask Me Anything

Hey, folks, welcome to another episode of Mental Health Matters. I'm Evan, your resident mental health and addiction therapist. Today we have another AMA episode. Ask me anything, or you could ask me anything about mental health, addiction. These are questions from you all. The Cad. Why is my dog so loud? Questions from you all in the Cadre sphere, as well as people who ask me questions on social media and just general questions for my clients and things that come up. So I have a whole bunch of questions, but we got.

Oh, my God. Like, all at once, our regulars joined, and then we have t boys. Now, I could see everyone who's in currently, but. So any of those who are joining, tell me what's going on. How's your day going? What are you up to? And then we can jump into some of the questions, and if you have any questions, that's even better, because then I could save some of my backup questions. If you have any mental health or addiction questions, we can go ahead and go over those. So let's see how you all are doing.

But this first question, I get this one a lot, and people ask what my credentials are, and I have a video on here that details and breaks down the different types of credentials a therapist could have. So I could tell you what mine are, and I could tell you what some of the other therapist credentials are. But I encourage you to go check out that video where I do break down all the different types of therapists that are out there. So let's go ahead and do that. So my credentials. So there's, first your educational credentials, right?

So for me, it's MSW, a master's of social work. So usually a therapist is going to be at a master's level. There's a few different general types of masters, and it depends. And it depends on, like, which state you're in or whatever. But generally, you have masters of social work, which is pretty universal. You have things like masters of counseling, masters of marriage, and family therapy. So those are the three big ones, and they could vary a little bit, but all three of those enable you to essentially be a therapist, but you have to get a license.

And so there are different types of license, typically, that correspond with each of those types of schooling, all of which enable you to do pretty much the same thing. It's just taking things, looking at it from a different lens. For example, mine is the LICSW licensed independent clinical social worker. In other states, it may just be like an LCSW licensed clinical social worker or licensed social worker. In other states, LSW. But it's all essentially the same thing. And then I have something called an LADC licensed alcohol and drug counselor for a long time, and not in every state did you need a specific license for it, but you would need a certificate of some sort.

But now most states have moved to the licensure model. And here in Minnesota, I think we're pretty much the first to have made it a license. And here you could do that at a bachelor's level. So if you have your LADC only, but you can't really do mental health diagnosing or treat specific mental health disorders with an LADC. So a lot of people have both. It's called being dually licensed. Having both your. Yeah, both full licenses. So that is good stuff. So a little bit of the difference, like a social work background, it does, you know, tend to put a little bit more emphasis on almost some of the basic needs of a client, of making sure that they're having adequate housing, financial support, food, all of those kind of things.

And looking at like the systems that may drive people into those situations and working to, you know, there's more of like a social justice lens very often of trying to empower individuals to, and help them improve their circumstances and, you know, at a higher level on the hierarchy of needs you have, you know, that's where some of the therapy could come in. So anyway, let's just move on. So that's my advice. See, I don't know. I don't know what's going on. I'll have to ask the app, but for whatever reasons, your comments show up and then they go away right away.

So Jules, will you put that back on? I really apologize. And we'll write down that we could look into that issue. So I did update the app. We needed to update it, but send it again. I'll just read it really quickly and answer it. But it looked like a good question. So in the meantime, when it comes to different therapists, they're all good. So some of the other lenses of focus. So masters of counseling is a little bit more general, kind of looks at all these different areas. Psychology, just counseling in general, focused on counseling skills, though, again, we all kind of learn all this stuff, just a different emphasis.

And marriage and family therapy is pretty straight up. A lot of couples counseling, family therapy, it's more of a specialized focus, though. They can do some of the stuff with mental health disorders. Well, okay. Notice a few comments pop up and quickly vanished. Alright, see if you could ask me the question again, but do it in a way maybe you could do it in a couple different parts so I could be sure that I could read it in time. So I'm gonna sit here and I'm gonna watch. See it pop up. Boom. I'm gonna get right on it.

So we're gonna do it that way. Let's see another one so we could do. Those are my credentials. So here's a question. Is there a cure for addiction? Now, sometimes you see these commercials for these treatment centers in California. This is the cure for addiction. Now, I think the best comparison is cancer. In a way, though, there's maybe not the same pure behavioral elements. Most people just get it, but sometimes there is a behavioral element is kind of irrelevant for this in a way, but maybe a little bit.

But let's say you choose to smoke and then you get cancer. So there is that behavioral element. So, you know, for example, individuals who continue to use high amounts of drugs and alcohol will then be at risk of developing the disease of addiction, essentially a chronic, like, altering of the brain, which essentially gives individuals, like, recurring cravings beyond their control. So the difference, too, is like, you may. Okay, advice on how to politely decline. Giving advice in an office drama when people come to you for advice.

Okay, there we go. That's a good one. Setting boundaries. So let me just do this cure for diction thing. So. But I mean, just to simplify it, right? So it's the brain condition with cravings and how it impacts the mind and body, how it becomes more chronic, more difficult. But same with cancer, right? If it goes untreated, you know, it's likely to get worse. I mean, sometimes it can go away on its own. We develop cancer cells. Not a perfect thing there, but once you have it, you're always at risk of developing it again, especially if you don't change certain decisions you make, what you put in your body, treatments, follow ups, that kind of thing.

So it's never like, really a cure, though. You can put your symptoms into remission with certain treatments, and they could stay that way whether you continue to do things or you just set it and forget it and you just never have it again. Is that a cure? Maybe. I don't know. So maybe I don't think cure is really a great word because, you know, treatments can arrest the disorder and the symptoms of it. And some may argue that for severe addiction, sometimes it still impacts your brain chemistry, your thought process.

You remain susceptible to it and susceptible to other sensation seeking behaviors, too. So even though I may not be addicted to substance anymore, maybe I struggle with other areas of compulsivity it's kind of a complicated question, but I think that's a better way of looking at it. So that's a good question. Speak wonder about boundaries. Right. So how is setting boundaries at work? So it sounds like, and I know this has been a theme for you where you're kind of the go to, you shoulder a lot of responsibility in many different areas of your life.

And I think I remember you said it has something to do with work drama. Right. So I think something simple is like, look, you know, maybe having like a general statement of like, I think it's best to, you know, maybe stay out of some of these situations. I would avoid, you know, something generic, but just being like, look, like, I understand this is difficult and I'd love to help in some way, but just for me personally, I gotta stay out of some of these, stay out of some of the inner, inner office politics or drama or whatever.

So just say in a way it's like not shaming to them, you know, just because why do that? But, you know, still being clear that, you know, I'm not, I'm probably not the best go to for advice on this just because I'm staying out of it, you know, and you can also just give horrible advice and they'll stop going to you. That also helps to just give outrageously horrible advice and stand by it and then probably just stop asking for taking you seriously. But, you know, simple boundary setting statement and doesn't have to be too over the top.

And then if they keep doing it, then there's level two, which I call hard boundaries. But if you check some of the videos out here, I have some videos on boundary settings. So check those out. You try to tell them, not my issue. Well, at some point it's just like, sorry, can't help. Sorry, can't help, sorry, can't help. My pastor used to be like, okay, well, I'm not going to talk about this anymore. I'm going to go back and get my head down and do my work. So I don't know, hopefully that was helpful in some way.

But I think it's just setting boundaries, holding boundaries. So for like, what did I have? Like I said, I wrote this in my book, but for soft, you know, more soft boundaries, or I call them frontline boundaries. There's different levels where there's preventative, where you set boundaries before anything happens and you have reminder boundaries which is like, hey, this is, you know, I'm reminding you this is my boundary. And then you have, it was like final front line, which is kind of like, hey, this is the last I'm going to do with this.

And then you move into hard boundaries or ultimate boundaries, which is kind of a statement like, look, kind of followed by like a consequence or, you know, a proposed reaction of what you're going to do. Basically, if you do this, then I'm going, you know, like, look, if you keep bringing these things up, I'm gonna, you know, talk to the boss or like, you know, maybe not go that far, but maybe in certain cases that would be talking the boss about air office politics. Sorry, I stretch a little head for some reason.

So, you know, that would be kind of a hard ultimate boundary of being like, look, if you do this, I'm going to have to do this, you know, but that, you know, usually comes after, I don't know, three, three other options you have before going to that length. So that's a great question. Anyone else is in here has questions. That's fine. Just watch and hopefully enjoy. Are there good options outside of like AA or twelve step programs for addiction? And yet the answer is yes, there are. That people find beneficial.

But, you know, the problem here is, you know, we like to think in absolutes. And with addiction, absolutes don't always apply quite well because addiction is a reaction. It is addiction. It could be addiction in and of itself, but often it could come from environmental factors, situational factors, upbringing, that kind of thing. However, I say it all leads to the same place, right? So when you use substances to fulfill a certain purpose, it leads to that same place of addiction regardless of what got you there.

So very often, let's say, I mean, one of the better differentiators I look at with things like twelve step programs is how severe is it? I don't think it's helpful and could actually be harmful to push someone in that option too soon because it is a great option and it was one of the only options for a while. So a lot of people got pigeonholed there. If you get like one DUI or something, just, you just go to aaeh. And that's not. Sometimes that's not going to be helpful because AA really is intended for individuals, even in its earliest forms, for severe alcoholics and drug addicts.

Now, some people actually do who don't go that far down or maybe wouldn't even be full addicts, you know, if they kind of just let time pass, but they find themselves in AA and just like it, you know, so they identify in that way and they have good sober network connections, support advice on ways of living a better life through the twelve steps. So people just like it and they stick around. However, for your average person the twelve steps would be a great, I'm sorry for your average severe addicted individual, Aana whatever a would be a really good option for all those reasons.

It kind of combines all these things that a substance use disordered individual would benefit from in one place where it's free, abundant, you know, there are some downsides. So I have a video about this about like twelve steps versus other versus like harm reduction, for example. So you should check that out if you're interested in this topic where you can, where I really break down the differences and when something's more appropriate, more detail than this. And then yeah, looking at more of like a harm reduction approach which may be helping individuals who still are choosing to use and maybe reducing harm and decreasing their use.

Now on the AA side they're like, okay, if you're really a severe addict or alcoholic, that's not, that's the whole problem in the first place is you can't control or manage it. Though sometimes people can be successful at certain stages or just every individual is different. However, the harm reduction can and also come in other ways, like medications, craving medications. There's ones for alcohol, there's ones for opioids and that kind of thing. And those sometimes can be done in conjunction with twelve step, you know.

But now there's also other support meetings that are, can be very helpful as well. Like smart recovery, which is kind of made as an alternative to AA that certain people find to be quite helpful. So it's got a lot of similarities, but it takes more of like a cognitive behavioral type approach, etcetera. So check that out. So if anyone else doesn't have any other questions, I think we'll leave it there for today. Well, you know what, let's do this one more because it really follows. So it's like what's the difference between substance abuse and dependence?

So substance abuse. So really there's no like perfect way of delineating. However, in the last main version of the DSM and the four TR, you had a differentiation between abuse and dependence. And essentially you just have a list. I don't remember. It was eleven then too, but something like that. Eleven substance use disorder symptoms, withdrawal, building a tolerance, how it impacts your life as far as relationships, mental health, physical health, physical safety, job, you know, so there's kind of eleven of those that are roughly like that.

And abuse would be like if you had like a couple, like you're like three to five or something, or two to five. And then dependence would be anything above that. So now it's more broken down into mild, moderate severe. So mild. The one to the two to three symptoms that you have in mild would be the old version of abuse. And it's still actually coded. It's a long story, but it's still actually coded as abuse in the international guide. And then the moderate severe are dependence. So like. But in a practical sense, like think about like, let's say a teenager who is abusing substances.

They're starting to have consequences, but they don't have that deep dependence with severe cravings, etcetera. But they're kind of more in those earlier stages or individuals who maybe, you know, they don't drink all that crazy, you know, like they're not like totally physically dependent or anything, but they drink heavily and have some consequences from it that may be considered more abuse, but the official definition is having two to three symptoms of abuse disorder out of eleven versus, you know, the four or more independence.

So I think that goes in well with AA because it's probably going to be more effective for individuals who are in the dependence versus abuse stage. Anyway, we'll be back Friday, dropping some new videos. Go check those out. Appreciate you all, take care. Have a good weekend.