(cheerful music) - Welcome back to Family Health Matters.

I'm Shelly Irwin.

With me today is Dr. Ron DeVries licensed psychologist at Pine Rest, Chris Rivera, Vice President of Clinical Services at Wedgwood Christian Services, and Kym Matthews, who experiences anxiety, with us to speak about it, so thank you all for being here on, what I would think is a topic that we all have been touched by, for lack of better terms, we might be anxious as we speak, even to this day we are.

Chris, how do you spend your day in this field, please?

- So, as Vice President, I oversee the integrated care component at Wedgwood Community Program, so in short, everything from psychiatry, to traditional outpatient therapy, substance use disorder, and some case management services.

So I spent a lot of time not just with the advocacy piece, but overseeing the programming of actual people getting help and treatment.

- Right, let me do note to you, Dr. DeVries.

your specialty, please?

- Well, I am a clinical psychologist, and my primary job is to actually see clients, so I see clients with anxiety, depression, oh, just a whole host of mental health issues, but certainly with today, lots of anxiety and depression.

That's probably the the number one thing that I see in the clinic office.

I also do some supervision there, and just recently started teaching at Calvin this past year, so.

- Very nice, giving back to others.

Kym Matthews we're calling sharing with you your title of Anxiety Advocate.

Is that okay?

- Yeah.

That's exactly what it is.

I keep these gentlemen in jobs.

(Dr. DeVries laughs) - Well, thank you for that, but here to share a story obviously.

Tell us a little bit about your anxiety.

Well, you know, I think anxiety started in my childhood, but I didn't recognize it until after the birth of my first child, and driving down the road, and had this intense, couldn't breathe, what is going on?

And then once it happens, you just have a fear of it happening again, so it just kind of spirals into this, "Oh no, what can I do to avoid that?"

Then the more you avoid, the more you spiral into this pit of not doing anything, and so, it's kind of, it's not like a broken arm where you can put a cast on it and it's fixed.

It's just kind of this ebb and flow of life.

Things will trigger it to be worse, and then you'll slowly get better and you're better for a while and then it kind of has a flare up again, so you just have to kind of manage it over and over again.

- Yes, well that's why we are here, to talk about that.

Dr. DeVries, what is anxiety?

Some of it's good, some of it's not.

- Right, let's talk about the good part.

We all actually need anxiety.

We need anxiety.

It's tied to our performance, and so for our performance to really be at that peak level, we need a little stress.

We need a little anxiety to get us up and going.

The problem is, there's a curve where, if we read that reach that apex, we drop off and our performance can drop off quite quickly, and so your story is actually pretty common.

People don't, something triggers it, and then what happens is you have this fear of a panic attack, even if it's not a full on panic attack, if you experience that very unpleasant, deep sense of dread, deep sense of anxiety.

A lot of times the heart is involved, there's sweating, there's hot flashes.

There's just a sense, "I'm in trouble," and really we know it's connected to our limbic system that is really tied to that fight or flight in our brain, and it's telling you you're in danger even though you're not in danger, and that's a really scary place to be, that your mind is telling you, "I'm in danger," and then you look around and there's not really anything that I can say I'm in danger of.

- Hmm.

Tell me how Wedgwood is involved.

- Well, I think the big piece that we're doing now is we're really getting the word out that we have availability across the board.

So psychiatry is an important role in anxiety, medication management, and also therapy, so that combination is crucial in anxiety management.

So right now for us is again, that community awareness, but really equipping our providers too, our therapists, right, with adequate tools and resources in the management of anxiety.

- At what point, back to you, Dr. DeVries, should Kym come to see you?

- Well, her story is actually the kind of story that I hear a lot.

I don't know, maybe what triggered it.

Sometimes, and I don't know if this is true for her, but sometimes there's actually trauma in the background, so something will happen and then they'll be talking to me and they'll say, "Well, this reminds me of a traumatic experience," or, "I've never told anybody about something that happened to me as a child, or earlier in life."

So there really are kind of layers of anxiety, and once you have that first panic attack, or once you've had that first anxiety attack, sometimes you have to reach out right then and there, because of the avoidance pattern that Kym talked about is really what you wanna not get in that cycle.

- Yes, Kym, expand again, this is not a paid session.

(all laugh) - That reaching out is so important.

That's what I wanna advocate for, because it is so easy to not reach out, but as someone said to me yesterday, once you out yourself, there are so many other people out there, and it's empowering to speak with someone else, and have that common thread, and so, my therapist has been great.

We spent a couple of years teaching me and looking into that trauma and learning, kind of maybe where this came from cause then I could know how to fix it, and it's like when you learn something new, teaching takes a long time, and so then I felt like she kind of just went into this coaching me, like she had taught me the skills, but I had to like run the plays.

I had to practice them, and then as I got better at practicing them, she just kind of stepped back more as a mentor.

And I would come in and say, "I did this and what do you think?"

She's like, "You did good.

You got it."

Or, "This might have been handled a different way."

Cause there's all these thinking patterns that are just running on a loop, and they were just really trying to get that loop rewired, and then the other little piece of it that's really important to me is that within the last couple of years we've had a daughter who suffered some trauma, some severe trauma, and as parents of adult children suffering with mental health, it's been really tricky and really challenging, and we're learning, there's not necessarily the resources out there, but they're hard to find, really hard to find, and both Wedgwood and Pine Rest have been significant in helping us navigate that, but our daughter's therapist often says to us, "I wish more parents were like you."

And I always say to her, "I think there are, we just don't know where to go," and so just talking about it and making it visible, I'm just, I guess one of those people who I just said, "I'm willing to share my ugly on social media because it helps us all."

- Chris, do you bring the whole family into Wedgwood with this type of treatment?

- Yeah, I mean, again, it depends on every situation's gonna be different, but we do have that continuum of care.

So at Wedgwood we've been known for years and years for the work we do with children and families, but really in the last decade or so, we've expanded to anyone and everyone.

So all ages, we do therapy for children, therapy for adults, we do psychiatry for children, adolescents, adults.

So for us it's really, a lot of the focus began with children and an extension of that is obviously the family.

So for us to be able to treat all of it, right, really comes back full circle.

- Dr. DeVries, at what point, I guess let's get into a little bit of the management, one feels a trigger, perhaps this kind of atmosphere, or I'm gonna jump in a big lake.

What's my management here?

- When I'm working with my clients, I always start with breathing.

It sounds so simple, but breathing is a critical, critical piece when we're talking about relaxing.

- So you bring in a physical component versus turning it off with my mind.

- Matter of fact, we know, and we're learning more and more about how the brain works, that so much of this panic anxiety that we feel is not in our cortex.

It's preverbal if you think of it that way.

That fight or flight is a reflex and it's not, you're gonna think about it rationally decide, "Am I going to fight right now, or am I gonna flee right now?"

It's an automatic, and so what you have to do is you have to actually train the body.

So breathing is one of the ways of training the body to say, "Okay, you're safe, you're calm."

How can I, and then we have to build on that.

That's just the first starting technique to really, because we're really talking about managing anxiety.

We're not talking about getting rid of it, and that's what I love that Kym's story.

It's just perfect.

Yeah, because it's really about managing, it's coaching, helping people manage their anxiety.

- Then the follow up question is cure versus control in general.

- I don't think cure really fits.

I think it sets people up for that expectation that someday I'm gonna not ever have this feeling again, which can be really, really disappointing, discouraging, even a sense of failure if it comes back.

- Kym, I know you're involved, you're wearing it on your sleeve here, Still I Run, Mental Health Warrior, you and are a local athlete.

How much does exercise, and being with these organizations help?

- Exercise is certainly helpful, but I think the bigger component is the community.

As you know, when we're out and doing our events, really just feeling connected to people is a huge help.

- Yeah, back to you, Chris, and Wedgwood Services psychologists versus psychiatrist?

- I mean, an easy differentiation is psychiatrists are able to prescribe medication.

Generally speaking, a psychologist's gonna do more testing, so like, let's say autism spectrum, A very common one is attention deficit.

That's a really popular kind of testing, and obviously psychologists can also provide treatment, and do therapy and often do, but the way a lot of common treatment models today in managed care facilities such as Wedgwood or Pine Rest, the psychiatrist is generally either a medical doctor, can be MD, DO.

You see often a lot of PAs, so Physicians Assistant NPs, and they're usually targeting the medication component, and working in these teams with the therapist as well, so it really becomes a collaborative effort.

And not everyone, I know a lot of people, there's some negative connotations with medication, so just because people are maybe viewing this and may have some anxiety or experience, it doesn't mean you have to be on psychopharmaceuticals, but it's good to have that availability.

It's good to be able to talk with your doctor about that or your psychiatrist, and just because you see a psychiatrist does not mean that you have to leave with a prescription.

I think again, that's another common misconception.

- What about the adage, face your fears?

Does that work?

- Well it's back to the avoidance.

It's how we face our fears.

It's the gradual exposure to our fears.

You can actually terrorize somebody just by saying, "Hey, you're scared of elevators, and we're just gonna get into an elevator right now."

That can actually be quite damaging to that person.

- You should know that I'm not real good with elevators, (all laugh) and claustrophobic tendencies are part of anxiety.

- They certainly are.

Phobias are under the umbrella of anxiety, so that would be another one of those fears.

So yes, we wanna face our fears because we don't want to do the avoidance pattern.

The more we avoid something, the bigger the fear becomes, so that's what's wrong with, "Oh, I just won't go there anymore, or I just won't do that anymore.

I just won't do that."

And then eventually the person might be so paralyzed that that's what we call agoraphobia.

They're not even leaving their home anymore because they're so afraid of the outside world.

We don't want that, but we wanna make sure that you're facing your fear in a supportive, kind, compassionate, I always talk about grace and compassion.

We have to give grace to ourselves.

We have to give compassion to ourselves while we're facing our fears because without it, it's too terrifying.

- Yes, boy, I had test anxiety as a kid too, now I'm starting to, did well, but I remember the night before an exam, I was a mess.

Kym Matthews, tell me more about, you self admitted you had to pull over to minimize symptoms from a panic attack, because you didn't wanna put yourself in a position where you could have been hurt.

- Yeah, and actually as a runner, I created a little spreadsheet earlier this year and transferred all my anxiety work into a running training plan.

So week one, like we would be running one to two miles to get to that 26 miles way down the road.

I wrote drive to Starbucks near my house, so I drove to the nearest Starbucks, then for a week or two, then I would drive to the Starbucks further away, since Starbucks is a little reward.

I got to have a little coffee, but I just gradually exposed myself to driving further and further until I could get to places that I wanted to go.

A number of years ago, I was a agoraphobic.

I couldn't leave the house, and I would get to the grocery store, and call my friend and just be, "Please come get me," and then I worked through this all with my therapist and about four years ago, drove out to Colorado, climbed to the top of a mountain, and took a picture, and said, "To all my friends who knew me when I couldn't go to the grocery store."

- What a victory.

So I got there, but then the pandemic hit.

We had this situation with our daughter and things just got out a little out of control again, so just working back through it, and I like that you said, I do say to people, it's kinda like diabetes, it's just something I will live with, and I will manage, and some days are gonna be better and the other days are gonna be tough, but I love that you don't wanna set yourself up for feeling and it's okay to be this, like we all have some sort of anxiety, it's test anxiety or driving anxiety, and it's taken a village of people to come around me, and that's the hard part is humbling yourself to ask for help.

We are not good at that, and I am really bad at it, but I've gotten pretty good this year to reach out to people and to say, "I can't drive.

Can you take me?"

- And what do you say?

I'll go back to my professionals, Chris, about the stigma.

One looks at Kym and says, "Get over it."

I would never do that, but, (all laugh) - [Kym] I do it to myself enough.

- That is honestly a lot of what I spend most of my time doing is that destigmatizing, because I think you brought up the the diabetes example.

I think as an anxiety sufferer, or someone who's suffering with mental health, one of the pieces is, "I should be able to will myself through this.

I should be strong enough."

Right?

Well, we talked about control earlier too.

There's a level of uncertainty, and that anticipatory anxiety, the fear of the fear as you've been experiencing.

So a lot of people fight those battles alone.

You talked about safety in numbers.

When you kind of outed yourself, you start to see like, "I'm not alone in this, like, I'm not the first person, nor will I be the last to have to manage this."

So I think the awareness piece is huge, and I think mental health more and more we're getting to a space where these conversations are commonplace, and I think the more comfortable people feel about talking about that, the better off we're gonna be as a community overall, and so even some of the data we've been talking about, like, "Well, is there a rise of anxiety?

Is there an anxiety epidemic?"

And I'm not necessarily sure that that's all the way accurate.

I think is the level of conversation and exposure that we're having about it now has created this platform where it's more open, where before it was more dealt with in silence, and I think that only made it worse for a lot of people.

- Hmm, add to that, Dr. DeVries - Well, exactly.

I totally agree.

I think a word like epidemic, actually is an anxiety producing word, and so it actually gets in the way of what we're really trying to do.

On one hand, we wanna help people understand this is a real.

This is a real and actually a very common disorder that people struggle with without adding to their anxiety, and that's why I struggle with the word of anxiety epidemic because it only makes you more fearful of anxiety, and then that's not what we wanna do.

Again, we wanna inform, teach people to take away some of the stigma without causing people to be scared of the next anxiety epidemic, wave of anxiety taking over the world.

- Yeah, what about something as simple as, does what I eat, would that make any difference in the day that I'm gonna have today?

In other words, if Kym woke up and had spicy foods or lots of salt, or that's an excuse?

- I wouldn't say it's an excuse.

There are certain things to really watch.

Certainly alcohol, recreational drugs really become, unfortunately a common way people use to cope with anxiety.

I'll just have a drink, two drinks, five drinks, and that becomes that part of the downward spiral, and I certainly have seen that in my office where somebody who maybe, much later in life has developed a drinking problem because they've been using it to cope with panic disorder that they've never told anybody that they're having.

- Kym again, share more about some of your management skills.

- Well, yes, definitely what eats what I eat plays into it.

Time in nature.

Just getting back to time in nature is very important for me.

- [Shelly] That's part of your job, don't you actually have a - - Yeah, and I started a walking group right when the pandemic started and we're still meeting and last night all the girls were like, "Oh, so I had such a hard day, I didn't wanna be here."

But we get out and walk outside and it's so much better.

In my studio as a trainer, I have a questionnaire, it's my three-legged stool, and so are you eating healthy, hydrating, sleeping, the physical things you can do for yourself, but then social connection, are you spending time with people?

Are you spending time in nature are really important pieces to managing your anxiety and getting that help.

Like you address the brain when you're in a panic attack, the reasoning part of your brain just shuts down, so there's no coping then, so you just kind of have to practice all those skills before you're in the middle of it, because there's no talking you out of it when you're in the middle of it.

- I'm jumping around a bit here.

Remind me of signs and symptoms that I'm having a panic attack and I've had one before.

- A panic attack is, well actually maybe a good parallel, or a lot of people get confused.

A lot of people will say, "I think I'm having a heart attack."

And they'll actually go to the emergency room and say, "I think I'm having a heart attack," because their heart is racing, their breath is off, they're sweating.

Sometimes they're even having muscle aches.

So we can actually feel very much like, "Hey, this is when I've read about a heart attack.

I think that's what I'm having," and so it's a very intense, often short, sometimes the duration can linger, but this short attack of your body is panicked.

I mean that's why we use that word.

It's a perfect word for it.

It's a panic attack.

- And again, a treatment for that at that time would go back to our breathing.

- In those moments or the other skills that you've been practicing.

This is why the coaching metaphor is just a really good idea, because if you have panic attack and you've been practicing mindfulness or meditation or breathing or getting out in nature, or calling a friend even, yeah, this is what I do.

I'm having a panic attack.

I can't really talk all that much, but she knows me.

I'm gonna reach out and we're just gonna breathe together on the phone, so it's the practicing of those skills.

- Yes, Chris, do we see, I mean, yes, we want management, we want lifestyle changes, but if one is severe enough, are there service animals for this type of diagnosis of anxiety these days?

- That's a good question.

Not my expertise there.

I'm sure there's a service animal for just about everything these days, so I wouldn't be surprised.

I have had some people inquire about emotional support animals and wanting letters from their therapists or their doctor for that, so that's not uncommon these days, but yeah, I think one thing that pets do in general too, right?

It allows you to kinda get outta your own head space.

So anxiety tends to turn things inward, and again, as we've been talking about how scary a panic attack can feel, it's very unsettling, so having, like again, someone there in close proximity or a dog or a cat to pet, that's another way to kind of ground yourself too.

- Yes, Dr. DeVries, is this something that is deep in our DNA?

In other words, Kym's grandchildren, will they be preset to experience this, or is that?

- That's a very complicated question.

In some ways because I think Chris's point earlier about the more awareness we're having about it, does that mean all of a sudden there's more anxiety, or are we just now talking about it in a different way?

And so it's really tough to know.

- I guess environment just versus genetic is the big, - I would say both.

I mean, I think we are born with a genetic code and we know the latest research shows that there are things that get passed and we are predisposed for all kinds of things, including anxiety, so that is there, but I don't think it's, I don't want to predestine somebody and say, "Well, your grandma had anxiety, so you're gonna have anxiety."

I think that that would be a wrong approach.

- What's happening in your family then, Kym?

Yeah, and that's an interesting, cause I've done so much research on that lately and the study of epigenetics, like two people could both be just predisposed to something and then certain things in your life might tip you in that direction, or might not.

So again, it doesn't necessarily mean that you will have anxiety, and so yes, my middle daughter has struggled with anxiety.

Actually, I think all my girls do to some degree, but my middle or my youngest daughter, I always say, is the recipient to the better version of me because I had gotten my therapy.

I'd learned my coping skills, so some of it isn't necessarily just DNA, but it's just the way I handled things kind of is caught, more is caught than taught.

I was really trying to teach them to do things differently.

so yeah, my girls are all varying degrees of it, but there's two that manage it really well, but one of my daughters was a victim of a crime a couple years ago, and that trauma has really triggered some mental health issues in her that we're trying to work through.

She's a fighter though.

She's giving it her best to work through this.

- Chris, back to Wedgwood, any evening services, overnight services, or is this mostly an opportunity for outpatients?

- So Wedgwood has a vast array of services.

We do have residential care and that is primarily for child and adolescents, but as far as the community based services, so like therapy, psychiatry, that's gonna generally be more a daytime, but we do have services into the evenings.

A lot of the people that we serve, right, work traditional jobs nine to five, so we do have our offices open in the evenings too for therapy appointments.

- Hmm, great.

In summary, what do you leave us with on behalf of your practice?

- You know, I'm gonna go back to what Dr. DeVries said I thought was really spot on, especially about how we reframe what anxiety means to us, language matters, and using myself as in my own experiences, I look at my own anxiety as, "What can I learn from this?

What is this preparing me for?

", versus seeing it as something that is crippling and affecting me, because I think, again, we cannot rid ourselves of stress or anxiety, but we can equip ourselves, right, to really look at this from the silver lining perspective.

So I would just encourage people to not see anxiety as it a curse, but also try to like really challenge yourself.

What are some ways that anxiety has landed me that job opportunity, has allowed me to perform in the football game, on stage?

What are the ways that anxiety has been a positive in your life?

- Is it true we're still afraid to public speak, we'd rather die than public speak or something as such?

How do we find out more about Wedgwood?

- So you can find this online, wedgwood.org, and that's Wedgwood with only one E, and again, like I said, we are not having any wait list for any of our treatment services, whether psychiatry or therapy, so right now is a great time to explore that.

- Great.

Dr. DeVries, what do you leave us with when it comes to a wide subject is such as anxiety?

- I know, I really just love the idea of managing your anxiety and I would put the parenthesis around that would be kindness and compassion, because I think that self-talk is a critical piece on how we manage our anxiety.

When do we need to push ourselves?

So sometimes we need to face our fears in that kind and loving way, and then when do we need to say, "You know what, I'm pushing myself beyond what I should, and I need to go take a break."

Go into nature.

Do some breathing.

Do some meditation.

Have some fun, Have some laughter even.

- And Pine Rest has services all over the map for us?

- Correct, we have several outpatient services and we have our inpatient hospital in Cutlerville, and can be reached at pinerests.org and the phone number is 866-852-4001.

We also have, in the last year, year and a half, it was pre COVID so maybe even longer now, just before COVID we've opened the psychiatric urgent care center, which it kind of runs like an an ER.

It's not open 24 hours a day, but it's open into the evening, I think eight or nine o'clock, and open on weekends, and if you are having a psychiatric emergency where you really feel like you need help, a crisis situation, it used to be that you would have to call and that's still available, and I shouldn't put that down, but now you can actually walk in, just walk in like an ER.

- Good, Kym Matthews, what do you leave us with?

What do you tell that one who is experiencing some anxiety?

- To play off what both of you said, like reaching out because that is twofold.

It helps you, and it helps others, but you, by helping others, you reduce your anxiety.

It gets you out of your head and helping people, so don't be afraid to reach out.

Still I Run is a running community for mental health people.

We're all over the United States and you can find your local running group here and get connected with people who really get mental health and yeah, don't give up.

Keep keep reaching out.

- And do you have your own business, right?

- Yeah, Kymmatthews.com.

Kym is K-Y-M, and yeah.

- Yes, and of course leaving with this concept of running your exercise.

It's the endorphins, that's the help there.

(Dr. DeVries laughs) - Endorphins, that's serotonin.

- Yes, serotonin.

And again, bottom line, the comradery to boot.

Well thank you very much and I've taken some notes myself.

So where's that elevator to tackle it?

(all laugh) Not one of us is perfect, but let's move on.

Okay, thank you all very much for this opportunity.

- [ Dr. DeVries] Thank you.

- on this special edition of "Family Health Matters", and as always, thank you for watching.

Take care.

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