Conversation with a Mental Health Counsellor

This week I had the pleasure of sitting down with Mental Health Counsellor, Lewis P., BSW MSW, Registered Social Worker.

We discussed mental health, and how we can monitor our own, especially during a pandemic. This post contains the interview in written form, but I will include the link to the video in case you prefer to listen!

Q: Tell us a bit about yourself and what you do.

My name is Lewis. I am a registered social worker who works in a interdisciplinary clinic. Meaning I get the wonderful chance to work with a variety of healthcare practitioners.

With that being said, before we jump in, a little bit of a disclaimer, that anything I say in this video does not constitute mental health advice. It’s not a replacement for talking with a practitioner.

Because I work in the province of Ontario in Canada, we’re regulated provincially so some things might be a little bit more Ontario centred than they are broader Canada or worldwide. But, mental health is for everyone, everyone works on it so hopefully it’s all applicable as much as possible!

Q: What is mental health and what is mental illness, are they the same? Are they different?

Our mental health doesn’t have to be ill health, and it doesn’t have to be fantastic, it kind of fluctuates, varies, and changes throughout our life.

So we all have mental health, and a lot of us have mental illness. Mental health is more to do with our state of wellbeing. Our mental health doesn’t have to be ill health, and it doesn’t have to be fantastic, it kind of fluctuates, varies, and changes throughout our life.

Mental illness is when we get more into the diagnosis or challenge area of things. As a social worker in the province of Ontario I cannot diagnose. I work a lot with other professionals like nurse practitioners, doctors, psychiatrists who do the diagnostic work and I do the treatment or follow up care work.

The difference is that you can have mental health and be doing very well, or you could be having mental illness and be facing some challenges there. 

Q: Right now, we’re in the midst of a global pandemic. How do pandemics affect our mental health? 

How much time do we have? Since the start of this pandemic it threw a lot of healthcare services for a loop. I was not expecting to be working through a pandemic, at all, so for myself there had to be a lot of education as the pandemic started.

As things were starting to lock down, what I was seeing a lot from people was excitement that they were to be working from home. This is all well and great until people started to realize they had to work from home. Typically it’s a lot easier to separate our work life and our home life when they’re physically in two different places, it’s quite a bit of an adjustment to actually have to bring your office into your home. We started seeing people needing to differentiate more between going to the office in their house versus leaving “the office” in their house and being just at home.

People started to notice a little bit of a difference with their kids. They couldn’t go to school, at least in Ontario since March, up until the end of the school year. Parents were noticing their kids were acting out a bit more or didn’t understand what was happening. They were suddenly ripped out of a routine that they’re used to, especially if they’d been attending school, and suddenly there was no more structure. We’re scheduled beings, without a schedule suddenly, especially younger kids who are maybe not able to articulate it as well, we’re thrown for a loop.

The added layer of having to stay inside, not being able to go anywhere. I don’t think anybody ever intended to spend 24/7 with their kids or with their significant other. Of course we love them all, but sometimes we need a little bit of a break. Everything was closed and there was a lot of fear. I think the cabin fever of having to stay inside and not really having anywhere to go significantly impacted people’s mental health because we couldn’t do a lot of the things we were used to doing to take care of ourselves.

Well, you know what? I always stay inside, I always feel uncomfortable and I always feel scared. So now the rest of the world is kind of getting what I get every single day.

I heard a few people who have challenges with mental illness put it very interestingly, they said “Well, you know what? I always stay inside, I always feel uncomfortable and I always feel scared. So now the rest of the world is kind of getting what i get every single day.” Which is an interesting and profound way for me to look at it and understand some of my patients or clients a little bit better. 

Q: Could you explain, what is depression vs sadness?

Yeah, so it became almost trendy within the past few years to interchange depression and sadness. So, a lot of people would say I’m so depressed, when they were sad. This can take away from the fact that some people actually do live with depression.

The easiest way to differentiate the two is that everybody gets sad, but usually those feelings go away or stop. Or if we’re experiencing sadness, we can still enjoy things at the same time. When we look at somebody who has challenges with depression, it’s when that sadness becomes more persistent, and starts to impact pretty much every area of our life. If its very hard to find any joy or to find any kind of moment of happiness. If we’re feeling a lot more fatigue or lethargy and we’re not able to go about our day or our business as we normally would – that’s when it might get into the area of having a bit of an issue. Feelings of sadness might be growing into an actual depression. 

Q: I would say it’s become a trend for people to say they’re having “anxiety” when it’s an anxious thought. What is the difference between having anxious thoughts, and having anxiety or an actual anxiety disorder?

That’s a little bit of a two part answer. Again, everybody usually has anxious thoughts and sometimes those anxious thoughts can give us the motivation to start something. Students are a great example of this. They might have a term paper coming up that’s due tomorrow at midnight. They have a lot of anxious thoughts about it, but start their term paper. They’ll stay up all night and will get it done. Not necessarily the healthiest way to get a term paper done, but those anxious thoughts helped them get the work done that they needed to do. Sometimes we can use anxious thoughts to our advantage.

Anxiety on the other hand, is again when those thoughts take over pretty much all the aspects of our life. When we can’t function like we typically would, because we’re having so much anxiety.

So we know that with anxiety typically we look at the thoughts, feelings, and actions. We know that if you look at a situation, it’s not necessarily the situation thats making you anxious, its your distorted thoughts about the situation. These feelings are causing whatever your action or reaction to the situation is.

With anxiety or depression typically we look at what are the thought patterns? Typically with things like anxiety, the anxious thoughts are little bit more generalized, maybe catastrophized. You may look at something small as being absolutely huge, or you may look at something very specific and overgeneralize it to everything. With anxiety disorders as well, there’s a few different ones so I’m more talking about generalized anxiety versus a panic disorder here.

Just be mindful sometimes about the language that you’re using when referring to having anxious thoughts, or when you’re referring to being sad. If you live with anxiety or depression, use those as you will, but it’s not always depression or anxiety, sometimes it is sadness or anxious thoughts. Don’t stick with what’s “trendy” and say I’m so depressed or I’m so anxious when you’re not. Some people live with those things  and face those challenges and work through that, and someone’s wellbeing isn’t trendy. 

Q: With this pandemic, we’ve seen a rise in substance use on social media, particularly alcohol. Likely this is a coping mechanism, but not the healthiest. What can you tell us about substance abuse? How de we know if its too much? When do we seek help, not even just for substance abuse but for a deeper problem? If you could give some insight into that. 

Yeah for sure. So definitely noticing a lot of increase in substance use just even across social media platforms. As people again, spend all their time inside, they’re turning to alcohol, or using substances. And using maybe alcohol or drugs as coping strategies. So I would say number one if you have to ask if its a problem, maybe look into that a bit deeper, speak with someone about that. There are low-risk alcohol guidelines in Ontario. If you’re not in this province or country, you can always look up low-risk alcohol guidelines. Not to say that is the amount of alcohol you should or can drink. But those guidelines are the least amount of alcohol that you can consume that will have the lesser health effect on you.

If you’re finding that:

• You’re getting upset, and you’re turning to a substance;
• You’re anxious and turning to a substance;
• You’re sad or depressed and you’re turning to a substance;

There’s probably a good chance that you’ve replaced one of your coping mechanisms or that you just have the coping mechanism of using substances, to get past whatever is going on in your life. We know that that’s not healthy, we know that there are greater mental and physical health implications when people do that so those are some red flags to look into.

If somebody else is concerned about you, that’s something to look for. For a lot of people this is a big thing which brings them to the place of seeking help. Not to say that your partner or family or friend or whoever is always right, maybe they’re over-concerned, or projecting.

Even if you’re noticing you’re using alcohol or any sort of substance as a coping mechanism, start trying to replace it with something else. Start trying to cut down on the amount. There’s a thing called harm reduction in the substance use world. It’s where you lower the amount of a substance that you’re using to literally reduce the harm on yourself, your body, and your mental health. So if a person who is drinking four beers every night drinks three beers every night for the next month, fantastic, because that’s one beer less per night that you’re putting in your body. That is reducing the harm.

And maybe the next month its down to two and the next month its down to one, maybe suddenly they’re moving on to non-alcoholic beer. Harm reduction can look a variety of different ways but it can be a good place to start. And having a professional in your life, whether thats a mental health professional or physical health professional, a doctor, nurse practitioner to have that monitoring person is always beneficial. And be honest with them.

Q: Our final two questions kind of interlock. How can I monitor my mental health and what should I do if I’m concerned about it? And, what is self care? Should we be doing it for our mental health?

You don’t have to have a diagnosed mental illness to be seeing a counsellor or therapist.

So self care again is a trendy word or topic thats been floating around the past few years, this is not necessarily a bad thing. Self care is the intentional act of doing something to take care of yourself, your physical or your mental health. If you’re intentionally going on a walk after work every day and you’re intentionally going on that walk to be mindful bout letting go of the day or focusing on just the walk, this is a great way to start taking care of your mental health.

How do you monitor my mental health and how do you know when to get help? Number one, if you are questioning it, it’s probably worth looking into. You don’t have to have a diagnosed mental illness to be seeing a counsellor or therapist. There is a lot of stigma around seeing somebody for mental health problems and a lot of stigma still around talking about mental health. Its scary, its a big deal, but sometimes the biggest thing you can do is take the step to reach out.

In Ontario at least, you can even go on google and search registered social workers, psychotherapists, and counsellors in your area and you’ll get a list of practitioners. If you’re working with a family doctor, a nurse practitioner, even a walk in clinic, they can refer you to somebody that they may know.

Number one if you are thinking about it, reach out. It doesn’t have to be a permanent thing either to get help for your mental health. Maybe you go for one session, or four and its helped you and you feel like you don’t need it anymore. Maybe you’ll need it down the line. But its monitoring those things like:

• Am I obsessing and focusing on something a little bit more that I wouldn’t normally focus on?
• Am I experiencing a lot more feelings of sadness than normal?
• Am I able to find the joy in things that I used to – if I’m not anymore, whats going on?

You may be facing some type of challenge that you can’t necessarily deal with on your own or maybe you just don’t know how to deal with it on your own.

I talk with a lot of people who are like “No I know this, I know how to take care of myself, I know about self care”. Easier said than done. Even sometimes myself if I’m having a rough day I still don’t do take care of myself, and I’m a mental health professional. Sometimes we know those things and we just don’t apply them to ourselves. Sometimes it takes having somebody else remind you, “Hey you know you need to be taking care of yourself maybe you need to start being a bit more active about it”.

Try to get out of the house. If you notice you’re spending every single day in the house, and you’re not doing anything or going anywhere, get out of the house.

I don’t want to use the term unprecedented times, because its terrible but it’s not incorrect. Its okay to not get everything done that we normally would get done because of what we’re dealing with. You can only do what you can do. Try to get out of the house, if you notice you’re spending every single day in the house, and you’re not doing anything or going anywhere, get out of the house. If it’s for a ten minute walk at the end of the day, if it’s taking your dog out, if its just going and sitting on your lawn, just do something.

We know that with things like anxiety and depression we don’t necessarily feel like doing things to work at recovery but you just need to do it. Don’t wait for yourself to feel like you can, or to feel better. Still listen to your body, if you can’t do something, adapt. If you’re like “Oh I need to wait until I’m not feeling as sad to go on a walk”, just go out and do the walk. Then you’re gonna start working on not feeling as sad. That’s kind of what I mean by just do it.

We know food and nutrition can have a big impact on your mental health as well and the challenges you might face there. If you’re eating sugar every day and not getting any nutrition, it will impact how you feel physically and will impact how you feel mentally. If you’re not getting any sort of movement or exercise, this will impact your mental health.

Those are the things to look out for, listen to the things your family and friends say, and over all, listen to yourself. 

Wrapping it up

Genna: Awesome, thank you so much. I really liked the point on you saying self care could be going for a walk not the idea like self care is spend 200 dollars that you don’t have on something wild. Because so many people think self care is going on a shopping spree or buying themselves something 

Lewis: You’re absolutely right, it doesn’t have to be expensive. If you’re tying feeling good to purchasing a 200 dollar bag, maybe also look into that. Maybe you’re starting to use shopping as a coping mechanism. Self care doesn’t have to be expensive.

A big part of the mental health journey is making the small changes or steps. If your house is a disaster and that’s really impacting your mental health and you pick up a piece of paper and put it in the recycling bin this week and thats what you’ve done, that’s fantastic, good for you. You’ve done something, you’ve made a change. The main thing is that you’ve noticed you’re not getting better or not benefiting yourself from your current situation and you’re changing it. You’re doing what you can to feel good.

Genna: Well thank you so much, I feel like this was a very insightful conversation and I hope its very helpful to some. I know it’s helpful to me even listening to this. Thank you for sharing your expert wisdom with us all.

It is very difficult to take the first step through the door, to make that first phone call to make the first appointment to even open up or talk to somebody. But its also an incredible act of courage and bravery to reach out for help. If you feel like you need help, do it.

Lewis: No problem, very happy I could be here. If I could leave on one thing it would be that it is very difficult to take the first step through the door, to make that first phone call to make the first appointment to even open up or talk to somebody. But it’s also an incredible act of courage and bravery to reach out for help. If you feel like you need help, do it. It’s gonna feel uncomfortable and challenging at first, but you’re going to feel good about it in the long run and its going to help. So take that step, do that act of courage, do that act of bravery for yourself and benefit you.

Link to video: https://www.instagram.com/whollygenna/channel/

Genna