Mental Health Series with Mary Mosier Part 3

[00:00:00] Rob Howe: Quick announcement before this episode, got some good stuff for you guys here. This episode, we are joined by Mary Mosier, licensed marriage and family therapist and a person with diabetes living with T1D. She previously visited us on episode 199, where we talked a lot about therapy and trauma and grief associated around diagnosis with diabetes. and we realized there were a lot of things that we didn't have time in that episode to cover that are instrumental to a person with diabetes journey with mental health and also starting therapy. So for November, 2022, National Diabetes Awareness Month, we're dedicating our content towards mental health. And we have a new page on diabeticsdoingthings.com, diabeticsdoingthings.com slash mental dash health. So slash mental dash health. And on that page, you can find all of the episodes in this series with Mary Mosier, but also we're going to be posting previous episodes related to mental health on that page. And most of all, during November, 2022, we are giving away four scholarships to see Mary Mosier and to get five therapy sessions with her. So four scholarships, five sessions each say that five times fast four scholarships five sessions each and in order for you to win you must live in california so what i'd like for you guys to do is to if you live in california go to diabetics doing things.com mental health and enter the giveaway or send it to someone that you know with diabetes living in california there are five episodes in this series and the first episode is also broadcast in spanish so it's our first spanish only episode on the podcast. So shout out to Eritrea and for Mary Mosier for being willing to do that in both languages. So again, check out diabeticsdoingthings.com slash mental health during November National Diabetes Awareness Month 2022. All right, let's get to the episode with Mary Mosier. Okay, Mary, we're talking about diabetes and its relationship to depression and anxiety, but we're also going to talk about depression and anxiety as human emotions. So to get us started and set the foundation for this, we're going to reference a study that I think has been widely circulated, at least in the online diabetes community and on the social media side of things as well. And in summary, it basically states that people with diabetes are three times as likely to suffer from anxiety and depression as people who live without diabetes. So let's just talk a little bit about that holistically. And on the three of us, I think I want to acknowledge and make it accessible to all of our listeners as well, that we acknowledge the truth in that statement, that we as people living with diabetes also are living with anxiety and depression, myself included.

[00:02:51] Mary Mosier: Yeah, yeah. I definitely experience anxiety. We're three for three, ladies and gentlemen. Yeah. And then again, like what you both were saying to normalize that. Like we said before, it is a normal human emotion. The concern becomes when it is affecting our functioning, right? Or when we are engaging maybe in behaviors and actions that are harmful to us and others that maybe our loved ones, we can be harmed because of the level of anxiety or the level of depression that we're experiencing. Right. So once it is like impacting our daily lives, that's like a telltale sign that we need some extra support and we all need it.

[00:03:41] Rob Howe: We do. And I think just to give our listeners some definitions, and these are obviously not totally inclusive, but we talked in our first episode about living in the present and working to really understand our present state of mind. And I think a really straightforward, maybe oversimplified definition of anxiety and depression is, you know, anxiety is really living in the future, not being in the present, worrying about what's going to happen or thinking about what's going to happen. And depression is the opposite, living in the past and thinking about the things that have already happened. Are those, I guess, you know, from an oversimplification standpoint, are those good ways to at least recognize when we're in those different states?

[00:04:22] Mary Mosier: yeah like I think for some extent for sure I do think a lot of folks experiencing anxiety especially folks that I work with where it is like gosh what if I fail what what if it doesn't work out or like this excessive worry or something not going the way that we would like or maybe because of a past experience certain things make us a little bit more anxious right and then with depression that can certainly be, you know, historical depending on our culture that we carry from generation to generation, a past experience, maybe like a loss, right? As we, like even when we talk about like grief, like something that changes that we thought was going to be a certain way that isn't. So all of those things certainly affect the way that our feelings flow, right?

[00:05:15] Rob Howe: definitely and i and i think too recognizing holistically like all of the different things and we're going to talk a lot about a lot about diabetes but you talked about family history or or trauma or grief like things that you may not even you know at face value even remember affecting you are kind of baked into your dna and are making you respond a certain way and just building that curiosity and awareness to uncover that takes real work and a lot of time.

[00:05:46] Mary Mosier: Yeah, it definitely does. Yeah. And I know sometimes to dive into the things that we've been kind of survival mode through, like, I don't know, that was rough. I don't want to go back into that. Like there's certain skills that we can develop and ways of coping. So we can go into those experiences that caused us harm or that are holding us in this like stuckness. So I think that that's the beautiful thing about healing. So whatever we are experiencing, there is a way to learn, nurture, to understand. Even if we do live with depression or anxiety, the fact that we know and understand it and know how to take care of it certainly helps us move through this world a bit more easily.

[00:06:31] Rob Howe: it does so let's talk about depression and anxiety related to diabetes what could that look like for someone who's listening to this and in your experience working with patients with diabetes yeah you know what are some common occurrences that you see you know from an anxiety and

[00:06:48] Mary Mosier: depression standpoint yeah so the us i see a lot of anxiety because someone is like what if this goes wrong, right? So especially if someone's newer to the diagnosis, so like, what if I pass out in a hike or what if I'm alone and I'm not able to reach the juice or, you know, whatever that experience is. And then for other folks, it's the stressor of the diagnosis, the lack of access is making me feel like I might not be able to live well with this diagnosis, right? I might not be able to live with diabetes because I don't have enough support yet. So just even acknowledging like what, what we have the power to do, how we can advocate, like who are the people that can support us with resources? Because I think if you're diagnosed later in life, your idea of your life looked a certain way. And now we are learning to move through the world and in a very different way than that we would need to. So that for sure will cause depression, for sure will cause anxiety to varying degrees. Right. And, and it's okay to acknowledge that

[00:08:03] Rob Howe: and be in that as well. And I think too, like that's really grieving, right? Right. Grieving for a life that you had seen for yourself and plans that you had made that had derailed. But I also think like there's and I know I'll use you as an example because I know you have had diabetes longer than you can even remember. That's always been your your normal state. Yeah. And I know many of our listeners are likely in the same the same category. So how does that manifest itself in your own life? Do you, you know, do you find yourself at times living in the past wondering, you know, what if or, you know, or if this wasn't my reality, what more could I even accomplish?

[00:08:45] Mary Mosier: Yeah. So I know for me, because I wasn't like financially resourced growing up, I know that that was like a major toll. And I didn't know all the resources that were out there. Like when I transitioned from, you know, pediatrics to adult endocrinology services, like I went years without it. So I was definitely a lot more highly anxious and like really thinking about the financial. So for me, like I did have to live a little bit more in that survival mode state. Like I have to do all these things to get here. I have to complete this thing so I can be able to support me and my family, especially after like my father passed away when I was wrapping up college and thinking of going to grad school and having to pause that and all the student loans. So the stress looked a little different because I was trying to degree so I could be in a better place to support myself in my right. Whereas someone else that maybe already has access to the resources, their experience of depression or anxiety or grief might look a little different. And I think Like for me personally, I really try to look at the things that are in my control. And for me, like those beeps and the pump and all that stuff, because I came so later onto it, to me, it feels like a fresh, just fresh air. Like it just feels like, okay, if I had this back then, I would have been living a lot more comfortably. So just even acknowledging like that privilege. I know that right now diabetes feels like it's dragging you down. But what can I be thankful for for what I do have with this illness? I'm not saying that you're going to be like, yay, diabetes. I love you. Thank you in all the ways. And certainly not saying that, but acknowledging like.

[00:10:46] Rob Howe: You know, it's sort of a we're laughing because like we know what it's like to be woken up by an alarm or interrupted by a beep. And it's, you know, a really mature response to say, I'm grateful that I have this because I remember a time where I wished I could have had it or, you know, where I didn't know what my blood sugar was. And if I had, maybe I could have done something about it.

[00:11:07] Mary Mosier: Yeah, yeah. So that too. And I think sometimes we need to come back to ourselves in that way where, yes, it does suck. And let me grieve it. Let me be angry about it. Let me have all the feelings. And also, what can I control despite this thing that I never wanted or this illness that I never wanted? And I think that folks can come to a place where it's like, this is part of my life. And how am I going to keep moving with it? How am I going to be friends with my diabetes, even though sometimes this friend is annoying?

[00:11:44] Rob Howe: Oh, wow.

[00:11:45] Mary Mosier: And I have sleepless nights. Like, how can I do this so I can live the life that I want? Right. Because even if someone's an athlete, you can still be a diabetic athlete, right? You can still, like for me, I still am a therapist. And when I have my lows, I always have a drink near me. And I check my blood sugar before sessions. And sometimes it's running low. So I will say like, hey, we're going to pause. I need to do this. And we'll add five minutes to your sessions. Like I have my things at this point in my life where I can be really honest about it and real about it. and it's not going to cause a problem where someone might not privilege or feel like they

[00:12:25] Rob Howe: can't communicate. So we want to. Self-advocacy takes work. And I think.

[00:12:31] Mary Mosier: Oh, for sure. It's like a third or fourth job.

[00:12:35] Rob Howe: It is. Yeah. The reality. Third or fourth. Like, yeah. Because the second job is for sure managing the diabetes. Right. And then making sure that you have the space for it and then you can communicate that to others is it's a heavy burden. And I think acknowledging that as well is also like you met, you might be just tired from having to advocate for yourself or create space for yourself. And that's also okay.

[00:12:56] Mary Mosier: Yeah, yeah, yeah. And then also, like, I think sometimes when I'm working with families or with like, partners that are like this therapy is for my partner or for my sibling, or for my mom, whatever. They also want to know how to help. So I always I'm not going to give someone like, oh, just just ask them. But actually communicating, hey, I see that you're looking a little sad or that you're struggling. How can I help you? I don't know what to do. Neither of us know what to do right now, but we can figure this out because we love each other, right? So just even like speaking to the unknown can be really helpful.

[00:13:35] Rob Howe: I love that. And I also want to also acknowledge that it may not be as simple for some people who maybe they don't even know where to start. And I'd love to cover that as we continue on this discussion is what are some of the things that a person who is looking to get started can do if they're

[00:13:54] Mary Mosier: struggling with depression or anxiety? Yeah. Yeah. So if you're a person that feels like you want group support or therapy support, there are a ton of resources that we can all go to, right? So is that is that something that you kind of want to want to jump into as far as like yeah I think that

[00:14:19] Rob Howe: just because there isn't a one-size-fits-all approach and I think everybody also has their own individual preferences so you know like let's talk a little bit about some of the group options for example or or even as like patients come to you like how what does that journey and pathway

[00:14:38] Mary Mosier: typically look like? Yeah. So I know with folks and even just sometimes because I'm connected with some organizations, they'll just reach out about like therapy where they're at or like resources for parents or groups for parents or like connection events with kids or with teens. So their kids don't feel so isolated. So those are resources that are there for sure. If someone's not necessarily open or ready for therapy. Because the thing about therapy is that you are co-piloting with your therapist, right? So your therapist is your guide and they're here to help you find your truth, your answer, not tell you like, here's lists from A to Z, all the things that you need to do so this can be completely fixed, right? And I think a lot of folks try to help us that way where they're like, if you just do, but that's not really what we're needing. We're needing a lot of space to figure out what we need and kind of process those feelings. So definitely reaching out to different organizations. And even if I'm not in your state and you're like, hey, Mary, I need a resource. You're more than welcome to email me. I try not to engage in DMs, though, because it's not confidential. So if someone's telling me something really private, it's going to live in the DM world. and I don't know what that looks like ethically. So, but definitely there are resources and people in the community that you can contact. And did you want me to kind of share about like the steps of like figuring out therapists or specialties?

[00:16:19] Rob Howe: I would love to, yeah.

[00:16:20] Mary Mosier: Yeah, okay. So one of the things that I encourage folks to do is to kind of think about the environment person that they want to work with. So what I mean by that is like, am I wanting someone to be directed? Do I need someone that's more soft and nurturing? Is there, am I wanting to do like really deep work or maybe I'm just, I just need some skills and maybe do more superficial work more. It's just kind of getting me through the day. And, and I don't mean superficial is like a thing. Sometimes we just need to feed some skills to help us keep going. And that's okay too, because that's where we're at right there's no like right or wrong way and and as far as getting services like what what can i pay right so am i am i wanting to work with a community-based therapist maybe a university that offers free services because therapists are in training am i going to reach out to an insurance provider that i'm my medical insurance and see what resources they have for me under my medical, am I wanting to work with a private therapist that doesn't take insurance and maybe ask them for a sliding scale? Because that's a good thing to know. Or maybe if you're working with a private therapist that doesn't take insurance, like contacting your medical provider and asking them like, how much can I get reimbursed if I decide to work with so-and-so therapist. Because those are certainly options. And if someone's feeling like I don't feel comfortable in a one-on-one setting, but I would love a therapy group. That's for sure like a great option for a lot of folks or groups for parents or again, for kids. So they can feel like, wow, people actually do feel like what I'm feeling because it can feel very lonely, I think with any kind of illness. including diabetes or you're kind of like no one gets me but there are a lot of people that get you might not walk in the same shoes but we get you i love that you brought that up because

[00:18:32] Rob Howe: there's two things i want to focus on the first is i think that there is sometimes a stigma around counseling and around group therapy of like that there's something wrong with you and it needs to be fixed and i think that that is not that like that is not true always right and also So like fixing a person.

[00:18:50] Mary Mosier: I'm not saying it's just because I'm a therapist. I'd like, who doesn't need support? Like, and you don't.

[00:18:56] Rob Howe: Who among us?

[00:18:57] Mary Mosier: Yeah. Like we all need a person. Even if someone's like, you know what? I don't have this big trauma experience, but I need like this space holder that's going to objectively listen. Because I think when we love folks in our personal lives, we're just like, I'm not getting a solution. Let me fix it for you. And sometimes we just need someone to like really listen. and give us their objective view which sometimes I think you know like on a on a human note being like a sister being a friend sometimes I want to fix it and of course we want to do that for people that we love and they might not need fixing they just need someone to listen right and I think

[00:19:36] Rob Howe: even if that's all that you get out of that type of interaction like that is so positive that is the work and that is you know it's um I don't know I just would encourage people who maybe have been coming up with objections in their mind as to why they don't need or why they shouldn't. What if you flip that around and just said, well, what could I benefit from if I did open

[00:19:55] Mary Mosier: myself up to that? Yeah, I love that. Yeah. Yeah. And even thinking about like, what could I grow in? Right? Like, what is something that I could use support in creating ease in my life, even if it's not something major, right? Like, that is completely overwhelming. I also encourage folks to consider like do I want to do like telehealth does it have to be in person what time of day would I be most present and more ready because if we are doing like deeper work what am I trying to do that before I start my day at work probably not right maybe at the end of the day maybe on a weekend right and then like what what what do I think I need to work on or what kind of support am I needing from this therapist at this time? Right. So I think all those things are important to know. And also that you will have to work on things outside of meeting with a therapist because it can't just be like the 50 minutes or 45 minutes every week or every other week. Also like, what are the steps that I can take? And is my therapist supporting me and guiding me with those steps that I need to take or those practices or how we talked in our earlier podcast recording about like, what are those skill sets? How do I ground? How do I meditate? Is my therapist modeling those skills? Or are they hearing me when I'm saying I'm ready for this or not ready for this? Are they pushing? Are they supporting me? Is this feeling good? Right.

[00:21:36] Rob Howe: I'm glad you brought that up too, because I think, you know, referring back to that podcast episode that we did earlier in the summer 2022 is a good place as well but as we kind of round out this episode before we started talking about you know acknowledging the need and like you know understanding that you know there isn't anything broken about you if you're seeking out help yeah we talked about uh friends and community and you know we've talked a lot about helping ourselves but how can we be better allies and supporting others if like you know or someone has opened up to you about their struggles, like how can you be an ally to them without crossing a boundary or sort of being overbearing? What is your advice there as like as a friend to someone who's,

[00:22:17] Mary Mosier: you know, struggling with anxiety and depression? I personally like to ask folks, like, how can I help you with this? Right? Like, I know one of my friends is, she's pretty close to being diagnosed with type 2. And she knows that I have type 1, and I work with folks with chronic illness. So when she told me that, instead of saying like, here's what you need to do, I was like, how can I help you? Do you want me to listen? Is there something I can do to take off your plate, right? So those are good questions to ask because my idea of needing help might look different from Eritrea's, from yours, Rob. So I think that that can be really helpful. Or if there's someone who's telling you, you know what, calling the insurance company to get this approved is really tiring me out. It's like really causing a lot of anxiety. Okay, let me call or like I'll be on hold and then we'll rotate because sometimes you're on hold for hours. So, or like I need help with resources to help me find a therapist. I think folks have done that where they're like, I'm trying to find a therapist for my spouse and I think you guys would be a good match. And then we schedule a consultation so someone can call on your behalf, but the actual person will have to be present And that communication.

[00:23:37] Eritrea: Right.

[00:23:38] Mary Mosier: It's just support. Right. That's how I started therapy. My best friend asked me. I was like, I can't even make the call. Right. So she just found the providers in my area. And she's like, sure, 10 people. Pick one and I'll make you an appointment. So it's sometimes just having that little push to get you there can be the support you need. Yeah. Or for someone like just for someone to honestly say, like, I see that you're struggling or it worries me when I see you this way and I love you and I want to help you. I don't know how I can do this for you, but I want to, like, because I love you. So that's where the like the communication part's important. So you're not telling someone like you're messed up, you need therapy. But saying like my experience of this is and I want to support you, not like you're doing this wrong or like you're laying in bed too much or you're just angry all the time. We don't probably don't want to because that's really pointing at like what you're doing. Instead, just saying, hey, I'm concerned. This is how I'm feeling. How can I support him?