[INTRO]

Hank: Hey everybody! We're doing a new thing today here on SciShow Psych. I have a friend who is a YouTuber; also provides information for people on the internet just like us. Also is an author of a new book and we wanted to have a chance to talk to her and maybe learn a little bit more about mental health, mental illness and what tools are out there, uh, for people who might need some help. Everybody, this is Kati Morton. Hello Kati, how are you doing?

Kati: I'm good, Hank, how are you?

Hank: I'm doing great, uh, thank you so much for taking a little bit of time to talk to us today. We are now in a world where I think a lot more people are aware of mental health and looking at themselves and being like, 'am I okay? Do I-' just like checking in and I think this is a good thing. But I also think maybe we know sometimes just enough for it to be dangerous. And--

Kati: [laughter]

Hank: And so having a guide, having something to connect with to help me figure out, like, okay I know that I need to be aware of my mental health but like what does that mean? And--and when do I know if I need to talk to someone or get help or, uh, or deal with something that is becoming a problem in my life, um, I think that can be really hard. Because it's one thing to be aware, it's another thing to be, like, knowledgeable.

Kati: No, totally. And I do kind of agree that we talk about mental health and mental illness more and people are more open to it, but I don't think anybody's talking about what it really means or if something is going wrong how wrong does something have to be before I reach out? And that's kinda the goal of my channel and my book is to let people know that, a) you don't have to wait at all - I think everyone can benefit from therapy because, even for myself, it's just another perspective. And sometimes I'm like, 'wow I didn't think about that that way. Hmm', you know?

Hank: Mmm-hmm.

Kati: But overall, like, if we're talking about when we're going from having a mental health, which is like a physical health, we all have to take care of ourselves and eat and exercise a little bit and all that jazz--

Hank: [laughter]

Kati: --um, same with our mental health and we have to take care of that and if it switches from us being able to function in our life to a time when we're having a tough time,

like getting up is really hard, maybe going to sleep--getting enough sleep is hard, I don't have the energy to shower or, uh, spend time with my loved ones; if any of that that you normally can do in a day you can't do? That's when it's like...as a therapist I'm like, 'oh, you should probably see someone'.

Hank: But what is that process of seeing someone? I--I feel like I have no idea where to even start, like if I need a dentist I'm aware that there are lots of people out there who have trained at dentist school, and I can even ask my friend and say, 'hey, where do you get your dentist...done?' [laughter]

Kati: [laughter]

Hank: Where as, like, I feel--I might feel pretty weird to be like, 'hey, where do you get your mental health done?" and I think sometimes people don't necessarily want to, like, be out there and asking questions like that of their peers.

Kati: And I totally agree. Luckily people are talking about it more so hopefully we'll come around to that, because word of mouth is the best way to find someone--

Hank: Yeah.

Kati: --as the same way you'd find a dentist or doctor--

Hank: Yep.

Kati: --or a plumber even. Anybody who's gonna assist us with their expertise we're gonna want to make sure they're good at their job. And so aside from word of mouth I think another great resource is just to, um, to try them out and I know that that sucks, but, like, insurances have whole lists of people--

Hank: Mmm-hmm.

Kati: --um, and you can always go and check also, before you make an appointment, when you look a therapist/psychologist/psychiatrist up they're gonna have a license number and in each state we have a state licensing board and you can just Google, you know, Montana State Licensing Board or California State Licensing Board for LMFT, which is what I am, Licensed Marriage and Family Therapist. And you can see if there's been any complaints.

Hank: Mmm.

Kati: If anybody's filed a complaint, that at least tells you if anybody has a really bad review.

Hank: Mmm-hmm.

Kati: Um, but then as far as a good review, since everybody's so different, I think this is why people have a hard time figuring out how to find someone good is you have to--you have to make sure that you feel comfortable, you feel they at least get you to some extent and they're on your side. And that's really it.

And I think that's why people have a tough time because they think it needs to be this, like, crazy equation where we're looking for all these particular, um, attributes and--and specialties and really we just know that we need to feel heard and understood and that's part of what makes the therapeutic relationship work.

Hank: Is there a portion of this that you--you feel like is accomplished through your loved ones and your friends and then something that is external to that that is accomplished through therapy?

Kati: Um, yes. I think that getting to vent, and getting some, like, advice from someone who really knows you, like has grown up with you or, um, raised you or something like that--

Hank: Mmm-hmm.

Kati: --I think that does still--that is still important, but if that's not enough and we still find ourselves having a tough time, or, you know, often it's the blind leading the blind, like-- [laughter]

Hank: [laughter] Yeah.

Kati: You know? They're like, 'oh, me too'. Or, 'yeah that really sucks' but they don't know what to say else, which is fine, um--

Hank: Mmm-hmm.

Kati: If we find that that's kind of the case and we are still struggling to function right: if we're having trouble getting up or doing what we need to do even if we're talking to people and using our resources, seeing a professional is really where that kind of, like, comes together and dovetails with family and friends.

Hank: Obviously this is gonna be different for--for different people but, like, do you have a moment when--when you feel like you start recommending people looking for therapists? 'Cause sometimes people will say to me 'I think everybody needs therapy'! And, like, yeah, I mean I probably might benefit from talking for an hour to someone and I might like that and...who knows?

Kati: [laughter]

Hank: Like, that sounds nice.

Kati: Uh-huh.

Hank: But especially in a world where you don't have infinite resources, like you have to pay for this and sometimes insurance will cover some of it but I also don't know how that works.

Kati: Yeah.

Hank: Uh, when do you need to make that call?

Kati: I think when it's imperi--like, I'm kinda going back to the functioning. I think when it's impairing your ability to do things in life. So, like--

Hank: Right.

Kati: --if you love your job and your feeling so depressed or anxious or upset that you have to call in sick

or let's say you have a child that depends on you and you're not able to care for them in the way you want--you feel like you're being neglectful? Even though you're trying, like, the things you really want to do you aren't able to do it's really important that you don't wait and you reach out.

Hank: Right. And that can be for lots of different reasons, like this--this isn't just, you know, it--it isn't just depression or anxiety, like, there are many different kinds of--of mental illness that--that people might be dealing with.

Kati: Yes.

Hank: And when we talk about mental health and mental illness I think sometimes we, like, use those phrases somewhat interchangeably these days?

Kati: Mmm-hmm.

Hank: But, like, obviously when I talk about, like, my physical health and my physical illness those are different things. Like physical health is, like, not eating three Oreo's, which I just did, for lunch--

Kati: [laughter]

Hank: --right before coming downstairs. [laughter] But like, physical illness is when, like, I'm sick.

Kati: Mmm-hmm.

Hank: And I'm, you know, I like--I'm shivering in bed, you know? Like, it's different things; I understand the difference between them. But I don't know that we talk about them correctly in our society.

Kati: No, I totally agree. That's like the whole first chapter of my book is just the difference between the two, because, I thi--I honestly believe that people use the words interchangeably because mental health sounds nicer--

Hank: Right.

Kati: --and it doesn't come with the stigma associated with mental illness. But no one would feel bad about saying they have the flu, so why should they feel bad about saying, you know, 'I'm just a little depressed right now'?

Hank: [laughter] Yeah, it's like, 'I can't get out of bed' I'm like, 'I'm just having some physical health issues'. [laughter]

Kati: That's--and that's the thing, if you think about it that way it's kind of, like, funny.

Hank: Yeah.

Kati: You're like, 'why are you so weird about that'? But I think the--I think the mental health is something that we all should care for, and that's, like, taking time for things that make you feel good and happy, um, that could be spending time with loved ones, that could be petting a dog--

Hank: [laughter] Yeah. 

Kati: --it could be any number of things, whatever, kind of, fills you up. Those are just basic--the same way we take care of our physical health, like not eating three Oreo's...oops. Or [laughter] things, you know?

We're gonna need to do that for our mental health. And then--

Hank: Yeah, I mean three Oreo's is fine just to be clear.

Kati: It's totally fine.

Hank: It's a totally acceptable number of Oreo's, it's just that I should have also eaten something else.

Kati: Yeah, little more substantial...maybe.

Hank: I had a slice of ham and a piece of cheese too, so I'm just on top of the world.

Kati: Oh, see, that's good. Totally well rounded. All the food groups. [laughter]

Hank: [laughter] Um--

Kati: But I think th--that mental illness has such a stigma that people are afraid to just say something like, 'hey I'm just--I'm having a hard time and no--no matter what I do, like--'. Let's say when we catch a cold, right? It's not gonna help me to drink, I mean it will in the long run, but I'm not gonna feel immediately better if I drink water, have vitamin C--

Hank: Right.

Kati: --and just keep going, like that's just not gonna make it better.

Hank: Right.

Kati: And so when our mental health starts to deteriorate and it becomes a mental illness that's when, like, the normal self care things just aren't making it better. It--it just isn't getting better, um, and that's why--that's why people like me are here. To help out.

Hank: Right. Often times I will hear people say, um, you know, that we're just indulging in our--in our difficulties and you just need to pull yourself up. Grab the bottom of your shoe yank yourself out of bed and, like, that's how you get better. You need to go for a walk.

Kati: [laughter]

Hank: Um, and, on the one hand, sometimes, like, these are normal mental health practices; going for a walk is good. Oftentimes I will be inside of a room with no windows for long periods of time editing a video or something, and I'll be like, 'I feel bad! I'm sad and I'm angry and everything in m--everything in my life is going wrong'. And then I realize, 'oh, you know what? I haven't been outside--

Kati: [laughter]

Hank: --or out of this room for like eight hours'.

Kati: Totally.

Hank: So, like, that might be part of the problem. But there is more to this than that. And this attitude that you can just yank yourself up and you have to just have some discipline in your life...talk me through it.

Kati: [laughter] Yeah, 'cause that kind of...like, I know especially previous generations definitely feel like that and some--some people who are just like, 'toughen up', you know? 'Pull it together'.

Hank: Mmm-hmm.

Kati: And sure that works if we're just having a down day.

Hank: Mmm-hmm.

Kati: But having a mental illness--it'd be like you having the flu or maybe--if we're talking even physical illness as a whole, like let's say you broke your leg, that'd be like me saying, 'oh, just get up. Just pull--just get it together'.

Hank: [laughter] Go for a swim. [laughter]

Kati: Exactly. 'It'll make you feel better. Just take a shower', you know? 'Go run some errands you'll feel like a new person'. That--it just doesn't work that way, and I think that the sooner we can start seeing mental health and physical health on the same plane the--the less likely people are to suffer in silence for years, because that 'get it together; white-knuckle it; pick yourself up' nonsense really just doesn't encourage people to--to reach out and speak up. And mental illness is way more common than people wanna admit. One in five are affected, so that means that almost all of us are affected, 'cause that means we all know someone.

Hank: Right.

Kati: And I think that the--the more we're understanding of each other--I don't think understanding means that we're being, I don't know, like too soft and indulging ourselves, I think it's like: no, we're learning more as a society, hopefully we can take that education and make ourselves better.

Hank: Right.

Kati: And--yeah.

Hank: So when I'm looking for a kind of person to talk to: a professional, an expert, um, there are many different kinds of professionals though. So you're a licensed marriage and family therapist?

Kati: Correct. Ding ding ding!

Hank: [laughter] But there--there's all kinds of--all kinds of people. There's people who specialize in youth or in older people or, um, you know, different, like, occupational stuff, anger stuff, like how--it seems like there's a lot of specializations but also, like, broad categories at the top 'cause there's psychiatrists and psychologists which I always get messed up even though, like, I'm supposed to know this stuff. [laughter]

Kati: [laughter] You're not alone. Everybody gets them messed up. And there's--it's like any--I feel like every avenue we go down, like, career-wise has a ton of acronyms to go along with it--

Hank: Mmm-hmm.

Kati:  --that you get so used to saying that you're just like 'everybody knows what a LMFT or an LCSW or an LPCC is'.

And everybody else is like, 'what?'

Hank: Stop. [laughter]

Kati: Exactly. 'I'm already confused!' Um, in my book I break it down in much more detail, like, what each type of therapist/psychologist/psychiatrist has to go through to get their license and to practice.

Hank: Mmm-hmm.

Kati: But overall the most important thing to know is almost everybody can not prescribe medication, and they're there to work with you to talk things through, and they'll have different specialties based on what your needs are, but, like, don't worry about it.

Hank: [laughter]

Kati: Unless you need medication.

Hank: Mmm-hmm.

Kati: Then you need to see a psychiatrist or your regular general practitioner--they need to be an MD. A medical doctor. Because--

Hank: Mmm-hmm.

Kati: --I didn't go to medical school. And so I don't think it's appropriate for anyone who hasn't gone to medical school to give advice on medication, 'cause I had, like, two classes on psychotropic meds and that's it. So, that's really what I tell people is, like, most of it doesn't matter. Like--

Hank: Mmm-hmm.

Kati: --the difference between me and a social worker for a pattient's persp--from a patient's perspective wouldn't be any different.

Hank: Right.

Kati: Um, and, like, psychologists are the same too, I mean, yes they went to two more years of university, but clinically speaking it's gonna feel the same. They're still just offering therapy in whatever their specialties are.

Hank: And--and as a therapist are there times when you or your patient feels like it's time for more assistance than you can give them through therapy?

Kati: Yes, a lot of the time, especially because I specialize in eating disorders and self injury work. And so if my patients become either physically too frail to come to my office and I don;t feel like it's safe for them--

Hank: Mmm-hmm.

Kati: --or if I feel like they're needing more than, um, two sessions a week, which is all I'm in my office is two days.

Hank: Mmm-hmm.

Kati: So then you can be referred to what we call, like, a 'higher level of care'. Which really just means you need more support. And there's no shame in it or anything it--all of us are gonna need more support at different times in our lives and that can look like anything from adding in a couple of groups a week to going to a day program.

Whatever your schedule or availability allows, you know, we try to make room for it. And it can go all the way up to having to live in a facility or being hospitalized just to keep you safe and make sure that you get the help you need.

Hank: So, as a person who might be looking for therapy, like, what--what are the reasons why I would go to see a psychiatrist versus a psychologist?

Kati: I think a psychiatrist, at least nowadays because, uh, health insurance is just--

Hank: Right.

Kati: --not--not the best. Um, they do what we call med management. And remember psychiatrists are medical doctors, so they're managing the medication that they put you on. So, let's say you're in therapy and you're drowning in your symptoms, like, your anxiety has piqued you're having panic attacks all the time, you just can't--that's why I like 'drowning' so m--it's like you just can't get your head above water to even participate in therapy--

Hank: Mmm-hmm.

Kati: --and so that's where I really feel like medication can assist you. It's like a life raft. You don't have to be on it forever, but it's a way to get your head above water so you can practice some of the tools and behavioral techniques that your therapist might be offering.

Hank: Right.

Kati: And so that would be--the psychiatrist would be who you'd go to when you need medication. And then psychologists and therapists would be who you'd work with on the behavioral techniques and tools and things like that. Although--

Hank: Okay.

Kati: --there is one little caveat, not to get too in the weeds, that psychologists usually are the ones who do testing and assessment.

Hank: Mmm.

Kati: Therapists can as well, we just have to take some trainings. Like, I've done some trainings for that. But, um, they're--they're more apt to do testing and assessment. So if you need anything for your child or yourself to see where you fall in a different thing like that you can utilize their services.

Hank: Interesting. So you talk some in your book about cognitive behavioral therapy, which is something that comes up all the time on SciShow Psych, as, um, like, when--when people are doing research, like, finding that these techniques work well, like, actually, sometimes extremely effectively for common mental illness and disorders, um, and sometimes less so. It's still a little fuzzy to me exactly what it is, what I'm signing up for, and--and also, like, I think, probably is administered differently by different therapists.

Kati: Yeah, it depends on how strict each therapist is to following, like, a certain type of therapy, um, and the reason cognitive behavioral therapy comes up so much is because it's the only, like quantitative style of therapy, where--

Hank: Okay.

Kait: --we can run studies and we can see how many behaviors that you have that still are unhealthy and we can track those and give a number to it. Where most work is, like, qualitative where I'm like, 'how are you feeling?' and you tell me how you're feeling, like, we're ranking you based against you, not--so I just always have to say that because that's why CBT is so widely, um, administered and discussed.

Hank: Right.

Kati: And it's short-term.

Hank: That's why it's talked about so much is because, like, you can do research on it more easily.

Kati: Exactly. And so CBT's main goal is to figure out what faulty beliefs you have about yourself and your situation.

Hank: Mmm-hmm.

Kati: These can come from childhood, it could be everything from, like, I'll never be good enough to no one will ever love me, or what I want doesn't ever matter. It can be all these things that we've developed through our life and through experiences.

Hank: Mmm-hmm.

Kati: But we don't recognize those faulty beliefs until we get into therapy and they work with us to, kind of, track back to see--they'll ask--they call it downward arrow technique where you ask a bunch of questions like 'okay so if that were true then what would that mean?'

Hank: Mmm-hmm.

Kati: 'Hmm, okay, so then if that happened then what would that say about you?' Like we're kind of trying to figure out--I always, like, think of it like plinko, where you're, like, following down--dit dit dit dit dit. [laughter] To try to get to the faulty belief.

Hank: Right.

Kati: Um, and then once we know that we work with you on some different tools to track your thoughts and notice your behaviors, because CBT's belief is that, like, what are the beliefs we have turn into thoughts and those thoughts turn into actions and then we go round and round.

Hank: Right. Fascinating. Um, things I didn't know and should have!

Kati: [laughter]

Hank: We should do a whole episode on why CBT is the thing that we talk about all the time--

Kati: Yeah, that would be so interesting.

Hank: --because there's obviously a reason. There's also now a fair amount of internet therapy happening.

So just over text...like, typing to people. Is this a thing?

Kati: [laughter]

Hank: [laughter] Is it--is it--is it good? I've heard of it, I've obviously never done it, um, and I hear it being discussed a fair amount and also, you know, controversy around it as well.

Kati: Yeah, I mean, I--it's always--I'm always going to prefer to see people in s-- in my office in person.

Hank: Mmm-hmm.

Kati: Because there's a lot that can be lost over even Skype.

Hank: Yeah.

Kati: Like, for instance, I have pajama bottoms on, but you didn't know! Ha ha!

Hank: I--I still don't even believe you. [laughter]

Kati: [laughter] And so, I could be really fidgety and you wouldn't know.

Hank: Right.

Kati: I could have not showered, but I've made myself look ni--you know, there's a lot of things you can lose when you're not in person. And so I prefer to see my patients in person and will only do Skype or, like, you know, 'telemedicine' as they call it if I've already seen a patient many times and we're just--I'm on vacation or they're out or whatever. And texting you lose even more because not only is inflection gone, like the sing song of your voice how you know someone's talking to you if it's sarcastic or serious or what, um, but then you can't see them at all. And so, but--

Hank: Yeah, I feel like it'd be very easy to hide symptoms if I was just writing to you. It's almost like, 'this is fun, I can make you think whatever about me'.

Kati: Totally. And, I mean, not that--I don't want to assume everybody has, like, malicious intent because for some people that's the only resource they have and that's why I--I do find benefit to online options because, let's say, I'm part of the LGBT+ community and I live in a really rural part of the states and there's no one around me and I don't feel safe to talk about it. It is a great, safe outlet, and a way to find, maybe, a specialist if you don't have access where you live. And so I think that--that to that end it is very beneficial and it can be great, and a lot of my viewers have had success over online therapy. But, I w--I do think at the very least you should do video chat.

I don't think text only is really that helpful. Maybe more for a crisis, like, I love the crisis text line.

Hank: Right.

Kati: I think that's a great resource, and it's a great way to get help in, like, when you need it--when you're in crisis. But otherwise I think you should see each other.

Hank: Uh, you also talk some in your book about, um, toxic relationships. This is something I, uh, we--we get--I have an advice podcast--

Kati: Uh-huh.

Hank: --and oftentimes have no idea what to do with this; when people are in relationships where they f--don't--where--where they are clearly, you know, being manipulated or--or, you know, in situations you, you know, oftentimes you can't get out of because it's a relative.

Kati: Yeah.

Hank: Um, and often sometimes I think people don't know when they are the manipulative person and the toxic person.

Kati: Mmm-hmm.

Hank: And, uh, and this fascinates me because I think it can be such a dramatic weight on your life and such a difficult situation to extract yourself from. Um, and I think it's really important to talk about.

Kati: Yeah, and I do--I talk a lot in my book about, like, the most common toxic relationships and, like, the red flags you should look for, and then the way that the other person, the--the quote unquote 'toxic' person would be interacting with you so hopefully that gives people kind of more of an idea of what to look out for in themselves as well as in their relationships.

Hank: Mmm-hmm.

Kati: And I think overall, something I always go back to on my channel is, like, relationships should, for the most part, be beneficial to you. Not that you're, like, gaining something directly, but it feels good, you--you get to talk about your stuff, they get to talk about their stuff, there's this, like, mutual respect and understanding and communication, and if any of that is--is not on board, if you leave a relationship feeling worse, more tired, you dread, like, they call you on your phone you're like 'ugh'!

Hank: Uh-huh. [laughter]

Kati: You don't want to, and that's, like, a secret conversation you have with yourself, you know?

Hank: Yeah.

Kati: You know you don't want to reply but you're still, like, 'ugh': you feel guilty--

Hank: Mmm-hmm.

Kati: --and all of that that kind of goes along with, I think those are all, kind of, red flags for toxic relationships.

And all of have been in them, and all of us have been the toxic person 'cause we've all been through really hard times, like, there's no judgement around, um, around someone being toxic or not, and also it could just be a bad recipe. Might not just be one person, you just might not work out together.

Hank: Yeah.

Kati: Um, and so just acknowledging that and knowing that the best thing we can do if we're on the outside watching someone be in an abusive, maybe, or super toxic relationship is just support and be understanding, 'cause I spend a lot of that chapter talking about, um, abuse in relationships and how the stigma associated with that is much stronger and people don't recognize. 'Cause a lot of, uh, female friends of mine will say things like 'if a man ever laid a hand on me', you know, 'that would just be the end of it'. And so what does that say about someone who maybe has had that happen and is feeling really scared and doesn't know how to talk about it.

Hank: Mmm-hmm.

Kati: Um, so yeah, I think there are ways out, there is help available, and I think just the sooner we can recognize the signs and to start to take care of ourselves the sooner we'll start to feel better.

Hank: So to finish up, um, what are the--the sort of like, quick steps people can take? The--the sort of like path to go down if you're feeling like you need some assistance?

Kati: Yeah, I think the first step is honestly to talk about it. Start talking about how you feel with the people in your lives that are safe and that are supportive, um, because that may be enough. Like we talked about. Like if--if you're just needing to vent and you feel like you don't have anybody to talk to, like, finding some communities online as well as in person can really really help. But if you're at the point where it's really hard for you to just do what you need to do every day and you're struggling in school or at work or in your social life in some aspect, and you're just feeling really terrible I would call your insurance, if you're in the states, call your insurance plan, ask for a list and start there. Like, this sounds silly, but sometimes I'll tell my viewers, I'm like, 'pick a name that sounds nice'.

Hank: [laughter]

Kati: Because it can be overwhelming--

Hank: Yeah.

Kait: --and you can do some research online but it's really hard to find great reviews. It's not like we have a Yelp for therapists that's reliable.

Hank: Mmm-hmm.

Kati: And there are some resources, um, that you can look up to try to--like rate your therapist stuff, um, and you can Google those and see what's available and if they have them in your area--if they've rated those therapists. But make a few appointments and just be open to the idea that it can get better. And then just see how you feel with them. You don't have to make another appointment. If they're kind of a jerk or you don't like it or their office seems super stressful and cluttered and you're overwhelmed don't go back. Um, know that there's plenty of therapists out there, we just have to find the one that fits for you. And the sooner you reach out, I promise you, the better it'll be. And therapists aren't scary. We're normal people too--

Hank: [laughter]

Kati: --you just, you know? We're just gonna be there to help you and talk to you, so--people get scared, but it's just like another me on the other side and I promise we're very nice.

Hank: Well Kati thank you so much for chatting, uh, the book is Are U Ok?: A Guide to Caring for Your Mental Health. It's available in print and in audio form, Kati you did the--the reading of it, right?

Kati: I did. My very own voice. [laughter]

Hank: [laughter] And you can also watch Kati's videos at youtube.com/katimorton, it's K-A-T-I, and it's always a pleasure to have you and thank you so much for watching us here on SciShow Psych!

[OUTRO]