Mental Health Matters 🧠 - Ask Me Anything

Hello, folks. Welcome to another episode of Mental Health Matters. I'm Evan, your resident mental health and addiction therapist. It is a beautiful sunny day here in Duluth. We got Lake Superior in the background. So I'm going to sit outside for this one. Call it self care, I suppose, but be ashamed to be sitting inside. Anyway, so this is another AMA Ask Me Anything episode where I've gathered some questions from you all, the Cadre family, my social media, you know, just other questions. I've gotten things that have come up in my therapy sessions.

What up, Jules? So, yeah, Jules, what's going on? But yes, I brought some questions here and if you all have any questions, please let me know. Have a little interaction. That's what makes this fun. I don't have to find as many questions, so that's sweet. Anyway, there you go. I'm back. So one question I got right so is what are some of the differences between the trauma stressor related disorders like ptsd? So we all know about PTSD for the most part, right? A general understanding, going through something traumatic, an assault, combat, an accident.

Right. And then basically just being shaken up about it. Right. In the most simple sense of the term. But to an extreme case to where it impacts just about every part of you. And I think we talked about this, this is kind of the topic of my live last week, in case you missed it. So go check that out where I talk about the threat of trauma, how it impacts every part of our life. But in this case, looking at some of the differences, we have something called acute stress disorder. Essentially this is when you go through something traumatic, it shakes you up, but it's like right after it happens.

So PTSD, post traumatic, now within 30 days would still be post, but technically you would have to have these symptoms for more than 30 days for it to be PTSD. However, if you're having them less than 30 days, we'd call that acute stress disorder. And there's some other trauma stress related disorders. One called adjustment disorder. It's actually under that category. I never really realized that. I mean, realized it at some point, but later than I probably normally would have. But yeah. So adjustment disorder is kind of a joke among a lot of therapists because like let's say you need to bill insurance, you need a diagnosis to bill insurance.

And if you don't really have one, if they don't meet the criteria for depression, anxiety, but they need therapy, in your estimation, you could do something like adjustment disorder, right. So why would that individual need to come in and get therapy? For example, you know, basically just stress, right? I think that's just the best way. Like you're stressed out due to some new circumstance in your life, whatever that may be. It could be transitioning jobs, you know, situation with a family member being sick, you know, kid who changes schools and is having a hard time with that transition.

So that's the adjustment portion of it. Typically, someone will have, you know, more depression or anxiety symptoms. However, you know, at a certain point, after six months, or I forget the exact cutoff, if you still have it, then you probably would diagnose depression, anxiety, ptsd, whatever best fits. So it's a real phenomenon for sure. The other one, we have a new diagnosis and the newest DSM that came out a few years ago. What year was it? 21. 2020 21. And that was called Prolonged Grief Disorder.

Now, prolonged Grief Disorder, this is essentially when you have a loss. Now there's a normal grieving process. I hate using the word normal. The grieving is very normal, Right. If you have an extreme loss, however, this is like if you get stuck in that grief process, right? So if like a year later it feels like it happened yesterday and you're just like, you're just negatively impacted, it's hard going to work and all this, right? So that's. I mean, it's just another psychological phenomenon that we make a diagnosis to justify treatment and also to encapsulate certain psychological phenomenon with the human mind, with individual differences.

Every disorder may look different for each person. However we draw these broad categories to know, okay, this is fitting with depression, anxiety. There could be different causes, could be some different brain mechanisms for all of it. But, I mean, that's why we do it. Some people are, like, very against it, you know, I don't really take that view. I think it's important to have certain understandings because if we don't have a diagnosis properly, what, we can't match it with a proper treatment.

So the more we're able to do it, you know, there has to always be flexibility and leeway. But there's certain therapies that are beneficial for depression, anxiety, whether it's medications, lifestyle changes, therapies, different types of modalities. So that's where you would get that from. So we got that. I don't know if we did this one. Maybe we'll do one or two more. So this one is about using dreams, drinking dreams. And I think I did talk a little bit about it, but we can go over it again because I've had other people bring it up, but you know, very, very often people early in recovery especially will have using dreams.

And if you're sober from a severe addiction, you'll almost certainly have them. And that could be at the beginning, but, you know, they happen over time, and they actually take some unique forms. Sometimes people have using dreams and they can't actually use in them. They never actually use the substance. But in their mind, they're like, oh, I already had used it, or I'm trying to use it. And then they fear the consequences. It becomes like a nightmare. Right? Because that's what they're like. A lot of their life is dedicated to avoiding it.

So the nightmare becomes that I used. I let everyone down. I let myself down. Here are the consequences, all that. So that is very common. And they tend to go away over time. This one is about parenting. It was an interesting line that came up, and that was in regard to, you know, in dealing with, you know, in raising children, especially those who have, like, mental health struggles and just in general is about being what they call a shepherd versus an engineer. That a lot of times parents try to engineer the life of their children and they don't give them a lot of the opportunities to make some of their own decisions.

Whereas being a shepherd, as you're kind of guiding them in this general direction, maybe not with a border collie nipping at their ankles, but, you know, allowing them to make some of their own decisions and not trying to, like, micromanage every element of their life. And, I mean, there's a lot of, you know, theories and as to why people are more depressed and anxious. And one of those theories that's gotten a lot of attention is that, you know, over the last few decades, like, starting probably at my generation, you know, millennials or whatever, you know, that parents were much more like, anxious and safety driven, you know, forcing their schedules to be full, some of this, like, overachieve.

So. And that, you know, and then kids don't solve problems for themselves, right? So, like, for an example, it would be like cutting their food for them and in fear that, you know, they will cut themselves. I mean, now, obviously there's an age appropriate time for that, but, you know, allowing them to make certain decisions, allowing them to pray, play freely. There's a book, you know, I don't know any parenting books, you know, kind of can go in all sorts of different directions. And I don't think there's a perfect way for anyone.

I think it really is cater to the individual of how much direction, how much types of discipline, really just structure that they need. But a book called Free Range Kids. I just heard a interview with the woman who wrote it and I think it all started where she just like wrote a blog post or an article or something called why I let my 9 year old ride the Subway Himself. You know, and it just like caught a lot of attention. So super interesting. I remember as a kid too, I think one time a buddy and I, we'd done that like we took the train, went to baseball games, you know, at a fairly young age.

Although my friend like knew the sub. The train system like the back of his hand, he had like a hyper fixated obsession with it. So I was in good hands with him as far as not getting lost. But I think there is some merit to that, right? We don't want to, you know, and in the addiction world too, that's a big theme as well, you know, where let's say someone is in recovery and you do everything, you know, to try to keep them safe and it like, it makes sense and it's understandable, you know, but sometimes allowing them to make their own decisions, allowing them to experience the consequences of their decisions as a learning experience, I mean, there's limitations to that, but.

So I just thought that was an interesting concept that I wanted to share and I think that's kind of it for my. The questions I've gotten. So if you have any others, tag me on my videos, throw it in the community feed, shoot me an email or whatever, just. Yeah. So anyways folks, it's been real and we'll see you soon.