thank you good evening and welcome to this special mental health edition of doctors on call I'm Mary Morehouse a psychotherapist with Insight Counseling of Duluth and I will be your host for our program tonight on Stress and Anxiety this special program is here to answer your questions about mental health issues that may affect you your family or friends please call or email your questions and we will do our best to address them the telephone number is an email address can be found at the bottom of your screen our expert guests this evening include Paige Benson a licensed professional clinical counselor with map Behavior Health in Duluth and Teresa Guerrero is the director of student health and wellness at the College of Saint Scholastica it is membership drive here at PBS North so we have a bank of phone Volunteers in the studio to take your questions and calls of support now let's begin our discussion of stress and anxiety so great to have you both here tonight I'm excited about talking about this concept or this this topic it's something very near and dear to my heart so let's just start off right away Paige tell me a little bit about what kind of anxiety do you see in your practice well thank you for having me here tonight and I see young adults and adults and I see a lot of different kinds of anxiety I think that some people might not know if there's so many different types of anxiety I see a lot of just generalized anxiety see a panic disorder just situational anxiety from maybe transitions or change I also see a lot of anxiety that comes from like post-traumatic stress disorder phobias panic disorder so all different kinds of anxiety people come in with with concerns okay so anxiety sounds like there's a big umbrella over a lot of what you see and there are a lot of things that come OCD that type of thing also social anxiety yeah so all that Under the Umbrella okay Teresa tell me a little bit about what sort of anxiety you see in your practice sure and again I work in college mental health so working with college students and one of the things we know about mental health disorders and difficulties is as stressors go up vulnerability to mental health difficulties increases and of course colleges are released can be a potentially stressful time it's a wonderful opportunity for individuals to improve their life by their education but it has comes with a lot of stressors so I was really happy to be talking about this topic because it's really timely for our college students and their mental health right now we um one of the things that happens that's informative in college mental health is something called the healthy Minds survey and so colleges all over the country participate in that and one of the interesting pieces of information that came from the Healthy Mind study in 2021 was that anxiety had surpassed mood disorders and depression as the most presenting concern and in particular Paige was speaking about different types of anxiety disorders social anxiety topped the list which I've been in college mental health for 25 years that was really I'd never seen in particular social anxiety top the list yeah very interesting thank you for that and that actually leads me to so about three years ago this month we all know what happened right everything kind of shut down I had a class of 2020 grad from high school and it's she's a junior in college and I personally feel like it's still it has an impact on her so kind of under the through the lens if you will of of the pandemic and things like that what sorts of things do you feel like you know it has caused the Stress and Anxiety I know in my practice personally so when the pandemic shut down everything the um my socially anxious kids were so happy because they got to be home and then and the the other kids who fed on kind of getting that group dynamic like they got their energy from people were had the anxiety and then when everyone went back to school it flipped so that was something I saw in my practice Paige tell me a little bit about kind of through the lens of of this pandemic that we're kind of moving out of now or through how has that impacted what have you seen through your practice before during and now after well I can definitely agree that I the clients that had more anxiety you know before the pandemic um really liking to be a little bit more alone and isolated it really built their walls up even more you know getting really comfortable at being home and so then now it's even harder to break down those walls of feeling comfortable you know of going out because they were so felt so safe in that environment so definitely notice that the anxiety symptoms have gone up for that for those kind of people you know for the other like kids and adults I feel like that I see that experienced just like that socialize isolation that weren't really used to it I think they got a lot more depressive symptoms and that was just really hard to see you know just really low motivation just depressed mood hopelessness not knowing how to get out of it and then not having all the resources that we normally have and with students I've noticed just it's almost harder I see for them to get like the motivation to do it and then also I think that the pandemic fed to a lot of things online which is kind of confusing for kids sometimes and so just a little bit of like confusion and lack of motivation yeah great can you tell me a little bit about what you thought again through the through the lens if you will of of the pandemic what you what you've seen the change in your in your years of practice yes and I think we're still figuring out the impacts there's an another piece of data that I think is really helpful the Kaiser foundation in collaboration with the U.S Census Bureau looked at their their census data and in comparing 2019 to 2021 adults reporting anxiety disorders in 2019 was 11 percent and in 2021 adults reporting anxiety disorders was 41 when you see that represented on a graph it's really really significant so in particular to college students a traditional age college students because of course I see students of all ages and it's important to note that all demographics were impacted by the pandemic so every age group was impacted but in particular young adults so those age 18 to 24 were most impacted in terms of reporting anxiety disorders so yeah we're seeing a lot of students come into our counseling centers with experiences of Stress and Anxiety okay thank you so much the questions are coming in Fast and Furious so let's start getting to them so I think this is I love this question if you're in the middle of a panic situation panic attack or just a situation where you feel high stress in your body what are some quick ways to interrupt that and rebalance page yeah give us your your quick yeah trips or tips yeah to rebalance ourselves yeah one that I learned from my supervisor that was something I hadn't heard before was to eat a Sour Patch Kid because there's something with the sympathetic nervous system that kicks in when we're having a panic attack and the digestive system they don't really work very well together so it can kind of slow the panic down um if you can get into some type of like cold water or drink cold water the temperature it really changes the way that the brain thinks um staggered breathing really helps lower the heart rate so breathing in for like seven and exhaling for eight there's a lot of different breathing exercises but doing that will actually calm the heart the heart down the heart rate down and if you're in a panic you really want to work on getting the physical bodily symptoms calm down because you're you're not in your prefrontal cortex so you can't really think your way out of it you really need to calm the body down calm the body down so those are some real I would say your brain is offline yeah so you need to work on getting it back online like I hadn't heard the sour patch yeah it works I've had clients that yeah they carry them now yeah and what's good about everything that you just mentioned what I really like about that is you can do that almost anywhere yeah you don't just have to be in the perfect situation you could do that in a classroom setting you could do that while driving you can do that in a lot of different scenarios and that's what things I love about the breathing exercises but again everyone keeps some Sour Patch or other sort of like intense kind of flavor what what are your some some of your go-to's for like a quick quick in the moment of stress relievers I I this is always a favorite of mine yeah yes yeah and I really appreciate everything that Paige just mentioned because so much of it is stress lives in the body and so we need to speak body language to be able to calm that nervous system response down there is a book that I think really informs this that I would recommend it's called burnout by Emily and Amelia nagoski okay and it's a New York Times bestseller it came out in 2021 and it talks about completing the stress cycle so if there's a panic response or an acute stress response doing some of those things for the body to let the body know that you can calm down so any kind of physical activity and of course that could be running or working out but it could also just be dancing or moving in any way a walk they they recommend other things too like a hug getting a 20-second hug can let the body know it's okay another one of my favorites is breathing as well and I think experimenting with different types of breathing techniques for me one that I really like is called four or four eight breathing so just breathing in for four seconds a nice deep slow breath in for four seconds and then breathing out slowly for eight seconds so those are I think also there can be really speaking that body language sometimes being able to have a good cry or um engaging in something creative if you can just really quick be able to do some kind of activity music those kinds of things can help calm that autonomic nervous system down okay wonderful thank you so much um Paige we'll go back to you what role does healthy eating and exercise play in mental health a lot yeah um it's one of the first things that I usually talk to my clients about because I pull it from DBT which is dialectical behavioral therapy and it's one of the emotion regulation skills and the acronym is please and you check in on all of these to make sure that your emotions are regulated and it's your physical health your eating your alcohol or caffeine consumption sleep and exercise and if you do these if you make sure these at five are okay it's your foundation of yourself is a little bit more balanced and your emotional distress is going to be more balanced the eating like our our it's like our new brain in our gut right like the food has uh so much impact on us it affects our mood um it affects like the anxiety and the depression so really eating healthy and it's different for everybody so um I think Consulting with somebody on it is is a good idea and exercise is just awesome I mean you get tired so you sleep you sleep better you get endorphins so you feel happier and then you move your body so it's better you know for your physical body so great yeah great thank you um next question um I feel like my partner so but this could be a partner child has a problem with anxiety but but doesn't want to get help what can I do to help them and so like and and also kind of going to kind of shoulder to to jump on that more is what what sorts of things do you look for in your loved ones again whether either it's a partner or a child or a parent that has Stress and Anxiety that is um it it goes more towards that disorder than just normal everyday stress because stress is part of life but you know at what point do you feel like it's kind of that signal that this person needs help yeah that's a good question and while I think the stigma about mental health and accessing Services is going down it still exists or just for a variety of reasons um an individual might not be ready to take that step but that loved ones and friends and natural supports can do a lot just by being present and listening and a part of Stress and Anxiety is is that emotions get stuck and we have to be able to move through that stress cycle and move through those emotions so just that experience of belonging and listening and showing empathy and support can go a long way and then it's just planting seeds of encouragement about how there's also other kinds of support out there too yeah great thank you and Paige to kind of yeah to keep going along with that at what point does this everyday stress anxiety worries however we want to talk about it when does it start to kind of become into that disorder when does it when do you feel like it's kind of that that time that you feel like people should should reach out and and it's starting to affect them you know so what are the things that you look for that you see yeah usually I you look at to see like what areas of their life they're starting to not function very well in and so the different areas of that we look at are like social like are they engaging in their you know normal social activities um they're educational or academic like are they able to succeed in school and understand and process it occupational like are they able to go to work every day understand and concentrate their relationships like how are they functioning in relationships and then also just like self-care are they taking care of themselves are they taking care of their home and I think when some are one of those areas become really impaired and make life somewhat difficult or difficult than people I would urge people to go in if they're not already going in but definitely when life starts to get difficult in those in those different areas gotcha okay okay um great thank you because I think that that's kind of a big thing what at what point is this kind of you know getting to to that to that to that next level so um students that are returning to in-person learning they're kind of anxious about this kind of back which kind of we talked about a little bit at the beginning but what can what can people do you know online learning for a lot of unless we have snow days like I believe today but but you know a lot of different you know educational higher education elementary middle school high school are there starting to be like you don't really have a choice you kind of have to come in and that the kids who are really having a hard time with that what are some things that you know you that you would recommend to kind of get back into that into that school setting and in higher education we're having those conversations every day in many ways I think that the experience of the pandemic along with many of issues of social injustice and all of the stressors that have impacted our young people our young adults we are having to approach education differently and so um we're having a lot of conversations about that that some in some ways we have had to get creative in educational environments to adjust and to support students and just giving them the opportunity to slowly create new habits and of course academic stressors are something that impact a lot of college students and their the way that they were studying and learning during the time a pandemic was very different so I think we all just as communities of learning need to be patient with are young people as they make those adjustments and learn those new habits yeah yeah very important um Paige back to you um I um meditation and anxiety what what do you see with with the benefits of meditation and anxiety well I love meditation and I could talk a really really long time on it um but for anxiety I mean when you when you meditate the purpose of the meditation is to you know focus on one thing and then when you start to drift off is to pull your attention back and every day when we're worrying and thinking and going along with our everyday routines our brains are in these circuits of thinking that probably have been going for years and years and years and when we meditate we we try to get our brain to stop that circuit and when we do that over and over again we're able to like catch attention of like what our thoughts are a little bit more often and then when we're able to catch our thoughts then we're able to ask ourselves are those thoughts you know helpful for us or not and if not then we can try to reframe them which obviously helps some of the anxiety because a lot of anxiety is the worry about too many things in excessive so a meditation practice can be one to three minutes in the morning and you can use apps and whatever and it's all out there and it is a practice some days you're really good and you might only drift off a few times in the next you might have like complete monkey mind and not be able to do it but I I definitely recommend meditation for everybody and it helps so many things more more than just anxiety and it helps with the the the muscle like like anything else in life the more you yeah the easier it gets as we mentioned at the beginning of our program it is membership week here at PBS North Doctors on call is a special and unique local show that requires your support to make it happen each week we'll be back after learning about why your donations to PBS North are so important thank you Mary hi I'm Tom Jamar director of marketing Communications and membership services here at PBS North and I'm here with Ashley Smith our director of content and we're so happy you joined us tonight absolutely our phone volunteers are also with us tonight and have not only been taking your questions but also your contributions doctors on call is an iconic local show from PBS North that seems like it's always been here and thanks to your 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thoughts so what are some ways to help get those thoughts at Bay and get back to sleep well there's a lot of different things we can try for people who haven't heard of like sleep hygiene if you look it up online sleep hygiene also has just Googling it and looking at it has a lot of different ideas on how we can try to sleep better but quick tips on like what I usually would tell clients is that you know not watching the clock not going on your phone because that's just gonna like activate more thinking reading but not reading anything that you're really interested in they say to read something kind of boring so that you kind of fall asleep from it and if you are laying there for about 20 minutes or so to get up and to maybe like go take a drink of water and try not to turn too many lights on when you do it but like to get up and then go lay back down you know another thing too is because I like meditation so well they do have sleep meditations that you can maybe pop your earbuds in and listen to like a sleep meditation or a sleep story something like that essential oils Lavender is great for sleep and so much too depends upon what you do during the day and so again I would look into what are you eating what are you drinking um getting a really good bedtime routine taking a warm shower before you go to bed can be helpful because the decrease in your temperature kind of calms you down a little bit drinking some chamomile tea shutting your phone off you know going through all those different kind of nighttime rituals can really start to cue the body kind of like when we give our babies a bath before they go to bed and then they're all sleepy it's kind of the same for us yeah and I mean we're our bodies want to sleep sometimes we need to get that mind out of it yes yeah can I add just a little bit to that those are great these strategies and I think about this a lot with college students because sleep can be a real challenge for many college students and a part of that is just developmental for traditional age college students their their biorhythms are changing and they tend to stay up later and that's actually pretty normal developmentally but one of the things I work on with my college students is to try to regulate their timing with sleep and at the very least try to get up at the about the same time every day can start to regulate those biorhythms yeah I'm not very popular when I tell them that I want them to get up at the same time but I remember hearing that that message in college and it's it's a heart it's a hard one because we fight against what we really want to do it's hard for yeah if you sometimes you just want to sleep in I don't know you know but it does help with regulating yeah um and so we're going to just to stick with you for a second chronic stress and illness and those are kind of two different things so a chronic stress impact mental health and then can a chronic illness impact and how are those two chronic conditions I guess impact a mental health and anxiety yeah um certainly both of them definitely increase vulnerability for mental health difficulty and with chronic stress until you complete that stress cycle until you find ways of moving through that stress it just accumulates so we do see for individuals who've had a lot of chronic stress that it stress lives in the body and every system of the body is impacted so our digestive system our endocrine system everything is impacted so diseases can manifest in all sorts of ways from stress one of the things I notice with college students is that if they have a lot of stressors throughout the semester they're studying maybe they're needing to work many students now in order to afford College need to carry a job maybe they've had family stressors or stressors in their communities that there's often it's not at all uncommon I'll say to my students don't be surprised if after finals the stressors are gone the finals are over and then they get sick right when a semester ends and it's because their body has been accumulating that stress so some mindfulness about just taking extra good care of themselves when the stressor goes away and the same with chronic illness just the coping that you have to do when there's chronic pain and managing that can leave you vulnerable as well yeah absolutely thank you so much for that um all right Paige what's your favorite way to cope with stress what are your go-to things well I think it's really important when we have a lot of stress and anxiety to really try to again I've said this but calm the calm the body and calm the mind um and so for me if my body is kind of stressed and I feel like a little bit uh tense and stuff I really like to like take a warm shower take a warm bath a sauna or a hot tub if you have it is really good yoga is really good to like calm the body you know doing body scan meditation if you want to do that or progressive muscle relaxation those kind of things I think really can help the body relax and then for like relaxing the mind a little bit more like when we're really worrying and we're thinking it's like we're in this emotion side of our brain and to kind of pull it over to the left side to kind of quiet that a little bit I personally like to do puzzles but you can do puzzles or reading art um you can do just like a you know any kind of like exercise but anything that's going to really listen to music that's going to pull your brain away from the worry is really helpful for a little while to just kind of calm calm the brain down a little bit yeah what about you what are your go-to's Teresa yeah I love this question I know it's a great one um I probably my favorite thing is being in nature going for walks in the Northland we have so many beautiful natural resources so I definitely that's my favorite way but some other ways that I've been thinking about recently one thing that decreases stress is I think just social interaction and belonging so getting together with friends always helps me and I think was one of the things impacted that increased our stress vulnerability during the time of the pandemic and then I would also add humor I think is a really good stress reliever so sometimes my husband and I will watch Goofy tick tocks about pets that seem ridiculous and there's a good Belly Laugh a really good laugh is that releasing that stress that's in the body so those are a few I liked a lot of yours too but yeah those are a few other ones I'd add yeah my favorites yeah and that means pets if you happen if you're so lucky as to have a pet you know a cat or a or a dog or a bunny or whatever pet you have a goat whatever whatever that's amazing so things like that that are kind of your go-to's but I think what what this shows you is you know you two are professionals and we are and they're different we all have we all need to find what that is in our own lives and the reality of our own you know practice um to to figure out what works for us right you know and I think that that's just so find your space and find your place that that works for it works for you in lots of different environments because we can't always have I love to walk in nature we can't always you know the things that are kind of so a multi-level um kind of different ways lots of options yes give yourself a big suitcase of this so um see I think I just okay well back to you um how can I so as a parent and you notice that your kids are starting to become a little stressed and anxious that you're feeling a little concerned what are some good tips for parents when we're seeing our children and children can be any age um you know what what are some things that you can kind of helpful for parents to help their kid their child young adult to help get through stressful situations page well I would say one it really depends upon the kid you know we have some children who really are an open book and then other kids who kind of you know keep keep everything pretty close so depending upon like how open they are with it really is gonna determine what you're gonna do I always really encourage parents to read books about like if just to because a child's book on anxiety is going to be in their language and you really use you know analogies and metaphors and stuff that kids can understand and I just really getting them to understand that that anxiety is normal and that even if their anxiety is a little bit too big for them that you can manage it and it's not always going to be a part of them we don't want them to identify as like always being an anxious person that we there are tools that you can learn to try to calm it down I think for kids teaching them the emotional intelligence especially just about the body like what it feels like where does it live you know where are you noticing it so really just getting down on their level and you know asking them where it's at what does it feel like um and yeah just kind of talking through them with it yeah that's great because you know those younger kids that's that stereotypical kindergarten first grade second grade tummy ache I have a tummy ache yeah school that's kind of how it manifests and then older kids it can come out as anger you know that that type of thing so kind of being in touch and then another thing is maybe change if there's a change if some of that developmentally and maybe you could speak to that Teresa a little bit you know developmentally we kids change we all change but you know at what point and again I think because you work with college students parents a lot of times are away um or you know kind of that older child which is where my kids are all in that kind of that older um so at what point you know do you does that become worrisome as a parent and and for that that change piece yes and you know I think um just paying attention and being in tune with that one of the biggest most important things we can do is just be present for our kids listen and believe our kids and our young people and um really I think validating it growing up is tough and validating what they're experiencing and just being present it's it can be um difficult I think as parents to know if our children are struggling and suffering and yet just being there being a sounding board to help them think through what they can do I um when I talk with parents who are having their young adults come to college I talk about how really a part of the goal of parenting is from the time that our parent our children come into our life we're always letting go a little bit the first time they take a step the first time they have a sleepover the first time they drive a car with their license speaking of anxiety um and that is the goal that we're empowering them with some skills helping them to listen to their body and validating their experience as they continue to we've let go more and more as they they age yes I do think it's been too to tell your children that we're not always supposed to be happy we're not always going to be just in this like happy happy mood and that it's okay to feel you know sad or whatever whatever emotion we're feeling they're telling us something about ourselves and and to learn how to ride through that and to teach your child and to how to ride through it and to not like a helicopter or lawnmower out of their way so so that when they are on their own in college I've seen that where kids just don't know what to do because it's kind of been taken care of for them so it's hard as it hard it is is for for us to see our kids go through these Hard Times um we can like you said stand by them and and and guide them and and hope that we're gonna teach them to do this on their own someday teach them how to learn to tolerate that yes uncomfortableness that is a part of this inevitable part of life yes and to kind of and I think again not to kind of go back to the pandemic piece but again developmentally that was such a big three years that we you know depending on the situation we saw more of our kids I had two kids come home for spring break from college and they in March and they didn't leave until August it's lovely it's wonderful to have them all home not that I'm I'm complaining but it you know that it was they were out of their element and then you were there to show show them how to be you could kind of comfort them and to kind of to to sit back and and just have this be this uncomfortable anxiety spaces yeah that's kind of that's part it's it and it's not fun it's not fun and so that kind of goes back so you know this question of can a little Stress and Anxiety be good so can you speak can kind of expound on that a little bit more expand on that a little bit more of how like when it's I mean Stress and Anxiety is is good that's kind of the space where we have growth yeah you know and I know you see that a lot in college but can you speak a little bit about kind of how we can um change the um you know kind of change the the tone of it and when we can when the stress and anxiety is positive for us yeah how we can Tamp it back so it is positive yeah I know that there's a lot of studies and like um you know theories and stuff on like different uh like how the arousal or how anxiety can like be beneficial for us and I do know that like if our arousal is that like a good point and um meaning our like anxiety about a situation um our performance is a little bit better um so like if we're gonna like do a race or if we're gonna like take a test or something like um that arousal does do do a well for us however if it goes over like in these bell curves or whatever they are um if it goes over it then then it's not helpful for us because it's just way too much stress and it's debilitating the same goes for like if you don't have any like anxiety or stress about something that um you might not perform as well so the anxiety sometimes can be really good for that anxiety performance and I always tell people if you're a little anxious um like I was today is that it means something to you and so um trying to feel comfortable in your body in that stress and anxiety and knowing that you can still perform it even though you're nervous or anxious about it yeah yeah and I yeah we were all stressed a little anxious and we all showed up on time right you know like it can be motivating it is too much like anything in life too much of a good thing is a bad thing but not enough is not good either right um and so tell me a little bit about how you see like kind of that you know and I know the the the curve I call it the gray Zone this kind of high performance just the right amount of anxiety for the right amount of high performance what do you see again kind of in in the population that you see to kind of to talk to people about this um this stress is is is actually pretty motivating because you did get the A on the paper you got the grade you wanted or whatever yeah I think that Paige did a nice job of explaining that normalizing and letting students know that carrying a little bit of stress is your friend you want that because it will just increase that nervous system response to make you more alert that your body will start to do the things that need to happen so that you are just cognitively more prepared to perform so I think when you let students know that that can be that's advantageous and educating that it can work to your benefit to be a little bit stressed you stress not de-stress that you want a little bit of that yeah that's that's great um what about Paige tell me a little bit about procrastination and anxiety so people you know they procrastinate their Inc you know and then they get really anxious and then kind of that anxiety procrastination motivation kind of all those you know they they seem to be so kind of tied in together yeah well I know that procrastination um can cause a lot of anxiety and some people are very motivated by it and I know I work with some college students and work with just like different skills to give them to try to get them to be motivated ahead of time to not procrastinate and I know one thing I always tell my my clients is like when they're procrastinating is make a list of one two three and one are things you have to do right away to maybe the next day three whenever and you can only do things on list one you can't do two or three until one is done because sometimes our minds want to do the easy things and the more fun things and so I always say you have to do that before you can do this or that and then you have to do two before you can do three so sometimes just really working with that procrastination can obviously help decrease the stress yes hmm yeah procrastination makes in some ways we are wired this way our brains are wired to resist or avoid pain if you think about if you put your hand on a hot stove you pull it away you you we avoid pain so if there's and some kind of assignment or obligation we have that causes some discomfort we get avoidant and yet it become it snowballs the more avoidant the more anxiety so some of it's just some psycho education around how that's working and can you take one small step can we think about kind of what you were saying different steps let's come up with the 10 steps that you might need could you do one of those today and they're like normalizing just just enough and we're kind of hardwired to do that thank you I want to thank our panelists Paige Benson and Teresa Guerrero for their time and expertise tonight and for those of you who called in or emailed questions please join Dr Peter nalen next week for a program on eye problems when his guests will be Dr Charlie Aarons Dr Matthew Cossack and Dr Lisa Graham thank you for joining us tonight this type of programming can only happen with viewer support you can keep all the shows on PBS North healthy when you become a supporting member let's check in with Ashley and Tom one more time hi I'm Tom 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