How to Have a Conversation About Mental Health
Episode Description
Although the stigma surrounding mental health is gradually disappearing, it can still be tricky knowing how to talk about it. In this episode of Mind Your Mind, host Tim Unsinn and psychologist Megan Spencer explore how to have a conversation with someone about their mental health, including signs that you should talk to them, how to start the conversation, and some possible reactions to expect from the other person.What to Expect
- How to start the conversation
- What to say & what not to say
- Possible reactions to expect
Resources: Learn More
- National Institute of Mental Health (nimh.nih.gov)
- “Parent’s Guide to Teen Depression,” (helpguide.org)
- “Supporting a Friend With Depression,” by Dakota Family Services
Things to Think About
- Don’t wait for the perfect time or place to start the conversation. Instead, just try to talk in person and be attentive during the conversation.
- Never tease, joke, or give ultimatums to a friend who’s struggling with their mental health.
- Do you know someone who should talk about their mental health?
About the Guest
Dr. Megan Spencer is a clinical psychologist at Dakota Family Services. She is passionate about working with individuals and their families and highly values the therapeutic relationship. Dr. Spencer enjoys helping people better understand themselves and their psychological functioning. She looks forward to working with anyone who is looking to better understand and/or improve themselves or their children and families. Her practice includes diagnostic and psychological evaluations and individual cognitive behavioral therapy.
Transcript
How to Have a Conversation About Mental Health
Featuring Megan Spencer, Psychologist, Dakota Family Services
Tim Unsinn:
Welcome to Mind Your Mind, a podcast presented by Dakota Family Services, an outpatient behavioral health clinic, located in Minot, Bismarck, and Fargo, North Dakota. In this podcast, I will talk with our experts about understanding and nurturing our mental health and wellness. I'm your host, Tim Unsinn. Join me each episode as we explore the intricacies of our minds, decrease the stigma of mental illness, learn practical tips for managing our mental health and wellbeing, and recognize when it's time to ask for help. Join me now to mind your mind. Welcome to this episode of Mind Your Mind. Our guest is Dr. Megan Spencer. Dr. Spencer is a clinical psychologist and provides diagnostic and psychological evaluations and CBT. Dr. Spencer, it's great to have you on Mind Your Mind. Our topic is how to have a conversation about mental health. Great topic. However, before we get to the topic, a question I ask everyone early on, and that is, why do you do what you do?
Dr. Megan Spencer:
Well, I do what I do because I genuinely love helping people and I enjoy watching the journey of self-discovery, learning how to help themselves more when it comes to individual therapy. And when it comes to psychological assessment, it is a journey as well. And seeing people recognize things about themselves and learning more about themselves, which then in turn they have some direction to go to help.
Tim Unsinn:
Great topic as well, great conversation, how to have a conversation about mental health. The more and more seems like we are able to have those conversations more easily than say, five or 10 or 20 years ago. And I think that's a, that's a great place for us to be. So first, what are the signs?
Dr. Megan Spencer:
Yes. So first, when we're having a conversation about mental health, I think there's always some natural anxiety and worry that comes when we think about approaching or confronting someone when it comes to things that you're worried about with mental health. But first, I think it's important to understand what are some of the signs that might suggest that we need to have this conversation. And so in terms of signs, the things that I'm gonna just kind of briefly mention are gonna be out of typical. So when I, when I talk about these things, they're not signs that are very typical day-to-day behaviors or attitudes from that individual. So these are gonna be signs that are out of ordinary, different from what, what you typically see with that particular individual. And so some of those signs might be impulsive behaviors. So we all from time to time do things or say things that we are kinda like, oh, maybe we shouldn't have done that.
Dr. Megan Spencer:
But this is gonna be impulsive behaviors that are happening regularly and frequently and not in the same way that that person typically kind of behaves or, or does. And so impulsive behaviors might be they're all of a sudden, you know, suddenly snapping or very irritable with people, or even impulsivity with buying things or doing things that just seem very unusual for that person in what they do, or not functioning. And what I mean by that is, is not functioning as it relates to habits, right? So maybe all of a sudden sleep habits are totally off when someone usually had a pretty good routine and now everything just kind of is thrown off and they're spending all day sleeping or not sleeping at all throughout the night. Some of those habits could also be appearance, right? So when somebody is usually, not that we're always perfectly well put together, but typically not disheveled or looking a little off and dirty and, and like you, you just don't care.
Dr. Megan Spencer:
So appearance might change. Eating habits might change. So when somebody has been typically pretty good about trying to eat regularly, eat more healthy, all of a sudden you might find that those habits have decreased, significantly increased or a complete change in what the actual food that is being consumed. Also, talking about loneliness and despair, people sometimes give us the exact verbiage we need to know that there's a problem, we just have to recognize it and listen. Also, excessive worry or, or anxiety. Someone might, you know, we all have worry and anxiety from time to time, but if someone is like, oh my gosh, I can't even leave my house. Right? Like excessive worry to the point that you had never heard them talk about those types of fears or anxieties, others could be concentrating. This is, this is one that can be a little difficult because stress on some levels does impact concentration. And so that just can be, again, more regularly having that inability to focus and attend. Another sign could be substance use, so increase in alcohol use, or maybe they're reaching to other substances that they never had before. So those are all gonna be possible signs.
Tim Unsinn:
Alright, so that's some great information. It's a lot of stuff out of the, out of the normal. So once we are realizing this, how do we start that conversation?
Dr. Megan Spencer:
So here can be, I think one of the difficult parts is yes, we can identify things, but then it's kind of like, oh, what do I do? Right? So opening that door can be pretty difficult and I think I like to give a direct statement that might be helpful. So let's say you recognize a friend or a family is, is having one or more of those signs, right? And a conversation could start like, oh, it seems like something's up. Are you okay? Do you wanna talk about something? Or, you know, I've noticed that you're really just not yourself. Is there something that I can do to help? Or let's talk about that. What's going on? Those are very easy open statements that you can give that conveys a message of I care, I recognize something is wrong and I wanna help. So the other part of that is finding that moment or that time to have the conversation.
Dr. Megan Spencer:
And I don't think there's ever a perfect time. So that just doesn't exist. But it, what the point is, is having the opportunity where you and that other individual can be private and not feel that they're being exposed or others are gonna hear and not understand. So, so really thinking about and being thoughtful as to when you wanna open up that conversation and really how you do that isn't necessarily as important either, but making sure it's in person if possible because that's gonna be the best. And if it can't be in person then maybe through a zoom call. So you at least get that face to face and you can see kind of how they're feeling about that, opening up that conversation.
Tim Unsinn:
Do, do you feel that the conversations are easier to have today than say they would've been five or 10 or 15 or 20 years ago? Just because of all the attention on mental health?
Dr. Megan Spencer:
Absolutely. I think there's two reasons for that. One, I think the stigma genuinely is starting to go away. And people are starting to appreciate and understand that our bodies and our emotional world and our psychological world is all very much connected. And so it's so important to take care of all parts of who we are. But I do think because that stigma is, is lifted and it is better than it used to be. That's a huge piece. But the other is the resources. And I think maybe five or 10 years ago, there weren't those resources and that information that really allowed people to understand mental health for what it truly was versus this sort of scary dark, ooh, let's hide it under the rug and we don't wanna talk about it.
Tim Unsinn:
Right? Great stuff. Okay, what do I do once I've initiated that conversation?
Dr. Megan Spencer:
So first and foremost, trust your instincts. Our gut tells us a lot of what we need to know. We just don't always listen. So first, trust your instincts because you know your friend, you know your family member and you know that what you are seeing and recognizing is off and you care about them, so you wanna help them. So being a good friend or a good family member has no manual, right? It is more about trying to understand who that person is and what they need in that moment versus registering what's easier, best for you if, if that makes sense. So I think it's not about finding the perfect words or like I said, even the perfect time or space, but it's finding the opportunity to have that conversation that can be very intimate for the two of you or the three of you, whatever that looks like, don't worry about having the perfect words or the perfect time.
Dr. Megan Spencer:
And so some tips to help during that conversation is ask if they've seen a doctor, do you have a primary care doctor? When was the last time you had an appointment? Others, keep it casual, keep it relaxed. Don't come at the person you know with this therapy professional attitude. Be chill, be relaxed, be calm. Like a calm normal conversation or chitchat versus this, I'm the authority and I'm telling you something. And listen, for goodness sakes, listen, that is a skill that we all need to develop, I think a little bit better. So the other part of that has just listen and make eye contact. Let them know that you are hearing them.
Tim Unsinn:
So you're listening to Mind Your Mind. Our guest is Dr. Megan Spencer. The topic is how to have a conversation about mental health. So we, we've talked about the signs, the conversation, how to initiate that conversation. So once we've done that, what do we do after the conversation?
Dr. Megan Spencer:
So here's where it can get tricky too. And I want to address a few situations that I think will probably come up more times than not. And so first, when you have this conversation and your friend is hearing you, and the next thing they say is, I don't want you to tell anyone, that's a difficult statement. And it's totally understandable, right? Because this is really vulnerable in private information. But telling your friend you'll keep the secret is by no means helpful. And at some levels would probably be a lie depending on the severity. And so the best thing to do is in that say, you know, I understand why you would wanna keep this secret, but I'm really concerned and I really wanna help. So who could we reach out to? Or what would you be willing to do to help yourself at this moment?
Dr. Megan Spencer:
So we don't have to keep it a secret. Something else might be, what if my friend rejects my help, right? What if they're like, Nope, I don't want your help. I don't wanna go see a doctor, I don't wanna call anyone. Well, that's legit and it's probably based off fear, right? And so at that point, I think sidestepping a little bit and having a conversation about your own struggles, I think we forget sometimes that we can really meet people where they're at when we talk about ourselves too. That, hey, I have struggled with that in the past, or I am struggling with that and here's what I did that helped. Right? So it's not, you're not trying to convince them, but what you're trying to do is meet them at a place that they can understand that everyone deals with struggles once in a while.
Dr. Megan Spencer:
Something else that might happen is what if your friend tells you they're being abused? Right? So what if they're being abused or they are experiencing other types of trauma? Or what if they say, I'm having thoughts that I don't wanna live anymore. Right? These are things that I think make people not have these conversations 'cause they don't know what to do with that. And so, yes, let's say your friend says they're being abused or they're a victim of something, or they're experiencing these suicidal thoughts, this is very serious. And first I think you should say, I'm really proud of you for telling me and I really want to help. So let's figure this out now and let's find someone that we can reach out to to help.
Tim Unsinn:
Yeah. And I think too, you know, as you're talking about this, I'm thinking, who would not want to go through this journey by themselves? I mean, if somebody is initiating the conversation, and if you are that person initiating the conversation, I think it's back on us to say, I'm here for that journey, however, I can help you, I will help you find someone, you know, just continue the conversation, right?
Dr. Megan Spencer:
Absolutely. And I think that the last thing that might happen probably and does happen is what if you have this conversation and your friend gets very angry and upset with you and doesn't want to talk to you, that's their prerogative, right? And they have a right to feel the way that they do. And if that is the case, don't shame them. Don't make them feel guilty. All that I think someone needs to hear is, I understand that you might be angry with me, but I want you to know that I care about you and I will always be here. So when you need to talk or when you wanna have this conversation, again, please reach out, but don't stop there. If you haven't talked to them in a few days, reach back out. Right? Don't just drop it at that point. So those are kind of, some things I think are pretty big roadblocks to why people wanna not have these conversations. <Laugh>,
Tim Unsinn:
That is a great conversation and that is how to have a conversation about mental health. Any other final thoughts?
Dr. Megan Spencer:
I think in terms of what you can further do, this just goes back to sitting down with them and doing a little searching, right? Okay, who are some, you know, if you don't have a primary care, let's find someone. Is it Sanford, is it Essentia? Where do we wanna go? Or yeah, hey, I saw this person a few years ago for therapy and I wonder if they're still, you know, seeing people otherwise. I think it's important to remember as the person starting the conversation to not take their behavior or their comments personally. They're in a difficult spot and what they might say to you isn't meant to be hurtful, but they're struggling. And you have to remember that and don't give ultimatums. Oh, for goodness gracious, don't give ultimatums. Don't say, I won't be your friend if you don't get help or you can't talk to me about this, then, if you are not gonna get help, that is absolutely the worst thing. Don't tease. Don't try to joke. Don't share this information with anyone that is in that, that wouldn't be helpful. Right? Don't get frustrated, don't get angry if your friend doesn't want that help. But make sure that they know you care. Don't shame them, don't blame them, but just let them know that you are there and you genuinely care about them because that in and of itself can be enough for them to get help and don't give up.
Tim Unsinn:
Sounds like you need to be patient, kind and caring.
Dr. Megan Spencer:
You got it.
Tim Unsinn:
Perfect. And for those of you that are listening to this podcast right now and thinking about sharing that conversation or you know, people that should be sharing the conversation or they're, they're maybe just a little afraid to do the conversation, have them listen to Dr. Megan Spencer on this podcast. Great information. Thank you for being on with us. Before we go though, how do you personally mind your mind?
Dr. Megan Spencer:
Oh, that is being with my family. So that would be my two little girls and my husband, spending time with them, whether it's at home, outside when we have beautiful weather or just honestly chilling.
Tim Unsinn:
Thank you Dr. Spencer. Appreciate your time and talent. Thank you for sharing that with us. Thank you for joining us for Mind Your Mind, a podcast presented by Dakota Family Services. You can't have health without behavioral health. Remember to mind your mind. For more information, links to additional resources, contact information, and much more. Go to Dakotafamilyservices.org.
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Shining Light in the Darkness with DBT (Community Chat Series)
Does it seem like your child is “stuck” in therapy, or engaging in dangerous behaviors like self-harm and suicidality? In this special Community Chat episode of Mind Your Mind, Psychologist Hannah Baczynski and therapist April Morris discuss Dialectical Behavior Therapy and its effectiveness in treating patients who have found traditional therapy unsuccessful. Learn about the 4 core skills of DBT and what makes DBT unique from other forms of therapeutic treatment.;
Does My Child Need Medication?
When our children are struggling with their mental health, it can be hard knowing how to help them. However, in addition to therapy, medication can be a viable and effective option for improving your child’s mental health. In this episode of Mind Your Mind, our host Tim Unsinn talks with psychiatric mental health nurse Amanda Daggett about how to know if your child needs medication, what the process is for a prescription, and how to tell if their medication is right for them.;
Depression in Children and Adolescents
Did you know that depression occurs in about 15% of children? In this episode of Mind Your Mind, our host Tim Unsinn talks with Psychiatrist Dr. Wayne Martinsen about depression in kids and adolescents, including signs of depression to look out for and how to know when to reach out to a care provider. They also touch on how to know whether your child’s sadness is caused by depression or other external factors and what you can do to try and prevent depression in your child.;
Recognizing Depression in Children & Adolescents (Community Chat Series)
It can be difficult knowing how to recognize and treat depression in children and adolescents. In this special community chat episode of Mind Your Mind, Psychologist Megan Spencer and Therapist April Morris discuss signs of depression to look out for, including both behavioral and physical signs that your child may be depressed. They also touch on the influence of environment, physical illnesses or diagnoses, and genetics on children’s mental health.;
How to Fit In While Staying True to Yourself
Humans are hardwired for social connection, but it can be difficult knowing where to fit in as unique individuals. In this episode of Mind Your Mind, host Tim Unsinn and therapist Christy Wilkie talk about the importance of using your strengths, interests, and relationships to figure out where you belong. They also touch on signs that you might not be staying true to yourself, as well as how to handle feelings of being left out.;
PTSD: Signs, Symptoms, & Treatment (Community Chat Series)
While often perceived as only relating to those who’ve experienced warfare, Post-Traumatic Stress Disorder (PTSD) can affect anyone. In this special Community Chat episode of Mind Your Mind, Psychologist Dr. Hannah Baczynski and therapist Lucas Mitzel explain what trauma is, how it affects each person differently, and when to seek treatment for trauma-related symptoms. They also discuss different treatment options for PTSD, touching on the pros and cons of each.;
Autism in Children & Adolescents (Community Chat Series)
Though autism is one of the most commonly discussed mental health diagnoses in the community, it is often one of the most misunderstood. In this special Community Chat episode of Mind Your Mind, therapists Lucas Mitzel and Falan Johnson discuss what autism is, how it appears in children and adolescents, and how it may look different between individuals. They also touch on how autism can show up differently in boys than in girls and offer intervention tips for parents and caregivers.;
Autism in Adults (Community Chat Series)
Autism is sometimes perceived as a disorder that only affects children and adolescents, but it is actually a lifelong diagnosis. In this special Community Chat episode of Mind Your Mind, psychologists Dr. Hannah Baczynski and Dr. Megan Spencer explore the symptoms and nuances of autism in adults, touching on the history of autism spectrum disorder, the research surrounding it, how autism commonly presents in adults, and more.;
Spirituality & Mental Health
Though spirituality is often associated with religion, it can mean much more than simply attending religious services or praying. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen define spirituality and discuss its relevance in daily life, touching on ways people experience, express, and cultivate spirituality. They also talk about the link between spirituality, religion and meaning in life.;
Setting Healthy & Realistic Goals
Setting goals is easy. Working towards them is hard. In this episode of Mind Your Mind, host Tim Unsinn talks with Dakota Family Services therapist Christy Wilkie about how to set healthy, realistic goals, as well as the importance of managing your expectations and staying persistent. Whether you’re starting an exercise routine, writing a book, trying a new diet, or building your career, keep these tips in mind when setting your next big goal.;
Facing Your Fears
Fear is powerful. It can cause us to avoid problems, people, and even opportunities in our life. But it can also be overcome. In this episode of Mind Your Mind, host Tim Unsinn speaks with Falan Johnson, a therapist at Dakota Family Services, about the function of fear and how to face it. Learn where fear comes from, how to identify it, and how to calm down and build confidence when you’re feeling afraid.;
The Three R's: Regulate, Relate & Reason
In this episode of Mind Your Mind, our host Tim Unsinn talks with Dakota Family Services therapist Jessie Mertz about the “3 R’s”—Regulate, Relate, and Reason. They discuss what each term means, how they build upon each other, and how this approach can help you calm others who are experiencing distress.;
What is Schizophrenia?
Schizophrenia is a chronic, complex mental health disorder that affects around 1% of people in the United States. In this episode of Mind Your Mind, host Tim Unsinn and psychiatrist Dr. Wayne Martinsen discuss the symptoms and implications of schizophrenia, touching on its many effects on individual and family life. Learn about how schizophrenia is treated, how it affects physical health, when it tends to develop, and how it is perceived between cultures.;
The Benefits of Being Outside
Are you feeling cooped up indoors? Join host Tim Unsinn and therapist Lucas Mitzel in this episode of Mind Your Mind as they discuss the importance of getting outside on your mental health. Learn about the benefits of green and blue spaces, activities you can do while outside, and how being outside can help improve symptoms of different mental health diagnoses.;
Dealing With Burnout
In this episode of Mind Your Mind, Tim Unsinn talks with psychologist Dr. Hannah Baczynski about the signs of burnout, how to prevent it, and how to know if your burnout is related to general life stressors or a mental health disorder. They also talk about the difference between fatigue and burnout, as well as how to support yourself and alleviate burnout when you’re experiencing it.;
Living with Chronic Illness
Many of us know someone who has been diagnosed with a chronic illness, or have been diagnosed with one ourselves. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how chronic illness can impact daily living and mental health, as well as how to seek support if you have been diagnosed with a chronic illness.;
Bipolar Disorder: Understanding the Highs and Lows
Although the term ‘bipolar’ is sometimes used as slang to describe someone who is moody or indecisive, true bipolar disorder is a complex and sometimes severe mental health disorder that affects the way a person thinks, feels, and behaves. In this episode of Mind Your Mind, host Tim Unsinn discusses bipolar disorder with nurse practitioner Amanda Daggett, touching on what the disorder is, what its symptoms look like, and how it can be treated.;
Social Media: Managing Emotions & Setting Boundaries
How much time do you spend each day looking at your phone? An hour or two? Multiple hours? In this episode of Mind Your Mind, host Tim Unsinn meets with therapist Christy Wilkie to discuss how social media use can impact our mental health, relationships, and behavior. Learn tips for monitoring your child’s internet use, as well as how to manage your own time spent on social media.;
Understanding OCD
While OCD is sometimes perceived as simply a desire to keep things neat and organized, it can actually have much more severe symptoms for those who experience it. In this episode of Mind Your Mind, host Tim Unsinn meets with psychologist Dr. Megan Spencer to talk about who Obsessive Compulsive Disorder affects, what its signs and symptoms are, and how to seek help if you or a loved one has been diagnosed with OCD.;
Breaking Bad Habits
Bad habits can be easy to start but sometimes very difficult to stop. In this episode of Mind Your Mind, host Tim Unsinn and therapist Falan Johnson talk about breaking bad habits, including where habits come from, how to know if a habit is bad, and steps you can take to stop it.;
Finding a Therapist
Are you looking for some help on your mental health journey? In this episode of Mind Your Mind, host Tim Unsinn and therapist Jessie Mertz talk about how to find a therapist, including what you should know when searching and what questions to ask when you meet a therapist for the first time. They also touch on what the letters after a therapist’s name mean, and how they apply to the type of services or treatment you might be looking for.;
Coping with Rejection
Whether it’s from asking someone on a date or applying for a job, we all experience rejection at some point in our lives. In this episode of Mind Your Mind, host Tim Unsinn talks with therapist April Morris about how to cope with rejection, including the common coping stages, the importance of acceptance, and how rejection can impact people differently.;
Borderline Personality Disorder
Like other personality disorders, borderline personality disorder is a commonly misunderstood and stigmatized mental illness. In this episode of Mind Your Mind, host Tim Unsinn talks with Lucas Mitzel, a therapist at Dakota Family Services, about what BPD is, how it affects someone’s behavior, and where to seek treatment if your child has been diagnosed with BPD.;
Psychological Assessments: What to Expect
Do you think you might be suffering from an undiagnosed mental disorder? If so, a psychological assessment might be able to help. In this episode of Mind Your Mind, psychologist Dr. Hannah Baczynski and host Tim Unsinn talk about what to expect from a psychological assessment, including what an assessment might include, what information you might receive from the psychologist, and what you should communicate with your psychologist before and after receiving an assessment.;
Supplements in Psychiatry
In this episode of Mind Your Mind, host Tim Unsinn and Amanda Daggett explore the topic of using supplements for mental health. In addition to talking about some of the most commonly used supplements like melatonin and St. John’s Wort, they also discuss the benefits, the risks, and the research surrounding various supplements.;
Seasonal Affective Disorder (Community Chat Series)
Feeling like you’ve got the winter blues? If you’re noticing symptoms of depression with the change of seasons, it may be a sign that you’re suffering from Seasonal Affective Disorder, or SAD. In this special Community Chat episode of Mind Your Mind, therapists Christy Wilkie and Lucas Mitzel discuss the common symptoms of Seasonal Affective Disorder, how it can affect other mental health disorders, and some useful tips, tricks, and resources for managing symptoms of SAD.;
Trying New Things With Confidence
Join Christy and Lucas, therapists at Dakota Family Services, as they share practical tips for building confidence when trying new things. From managing self-doubt to building resilience, this episode will empower you to approach new experiences with a positive mindset.;
Relationships are Hard
In this episode, Christy and Lucas explore why relationships can be so hard. Join them as they discuss the characteristics of both healthy and toxic relationships, talk about the difference between normal conflict and abuse, and help you discover your love languages so you and your partner can best express your love to each other.;
Is Everybody Anxious?
In this episode, Christy and Lucas explore anxiety. Join them as they discuss the signs and symptoms of an anxiety disorder, what you can do to decrease your anxiety, and how to best help loved ones struggling with anxiety.;