May 6, 2025 • 28 mins
This episode covers the mental load that many women carry. The self-imposed standards we hold ourselves to can become unbearably heavy. Dr. Alexandra Kohlhase, behavioral health psychologist, helps us reframe to celebrate our successes rather than focus on our perceived failures. We’ll talk about how to get started seeking therapy, the intricate relationship between physical and mental health, and the role of medication in managing mental health conditions. And while apps might seem like an easy fix for increasingly well-known conditions like ADHD, there’s no replacing the benefit you’ll receive from meeting with an Essentia Health provider.
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Episode Transcript
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Speaker 1 (00:00):
It's never a bad time to seek therapy with doctor
Alexandria Colhais.
Speaker 2 (00:04):
Whether it's anxiety or fear, or sadness, loneliness or abandonment.
If we don't deal with those, it shows up later
in our bodies.
Speaker 1 (00:12):
I'm Corey Jensen, your host for the Dare to Ask podcast,
a space created by women for women who want to
stay informed about their health issues as well as the
wellness of their kids. We've designed this to be a
casual conversation with real health experts to help us understand
our bodies, advocate for our care, and prepare ourselves to
have the conversation with our providers without feeling intimidated. A
(00:35):
place to talk like girlfriends do. A space that dares.
Speaker 2 (00:38):
To ask, constant internal dialogue. I think that we experience
that we do so much and it never feels good enough.
Speaker 3 (00:43):
We're here to make a connection. You've landed on the
Dare to Ask podcast show hosted by Corey Jensen and
sponsored by is Sanha Health.
Speaker 2 (00:52):
I'm a psychologist, so I provide therapy. I think that
everyone could benefit from therapy. You don't have to have
hit rock bottom. Who wouldn't like a compassionate ear we
could all use.
Speaker 1 (01:00):
That mental load. She can be a heavy one, and
when it comes to us women, the mental load that
we carry seems to be not only heavy, but fraught
with a whole lot of self imposed standards that we
attempt to hold ourselves to, and that adds to the heaviness.
I'm excited to have doctor Alexandra Colehayes. She is a
(01:23):
behavioral health psychologist. It's our inner dialogue, it's our voice
that seems to lead the charge in a lot of
our mental load, and she comes up with some great
ways for us to help reframe that so that we
can celebrate more of our successes rather than just be
looking and focusing on our perceived failures. We'll talk about
(01:44):
how to get started seeking therapy and that relationship between
physical and mental health. We're going to talk about the
role medication and talk therapy and ways we can manage
mental health conditions, including conditions like ADHD and how women
are being diagnosed with that more and more. We really
have a lot to unpack here, so let's get to
(02:05):
it as we dip our toes into the behavioral health field.
I thank you so much for coming in and being
a guest on this season. We are now in season
five of the dar to Ask podcast. We have successfully
been talking about women's health issues and our children's health
issues for five years now. Further way to dive deeper
into topics and the mental load, How would you describe
(02:29):
what that means for women? We could all have our
own definition.
Speaker 4 (02:33):
Yes, I would agree with that.
Speaker 2 (02:35):
I think it really is a very apt descriptor to
call it a mental load, because it's heavy. It's the
weight of all of the expectations that we place on
ourselves decietally, what's expected of us. The more women and
mothers I talk to doing the work that I do,
so much of it is a self imposed rules standards,
the very high pressure that we always have on ourselves.
(02:58):
And as a mom and a psychologist, I understand that
trying to balance the many obligations and trying to wear
so many hats at one time all the time.
Speaker 1 (03:06):
Don't you feel like it's always been the fate of
women generationally?
Speaker 4 (03:11):
Eve was getting how do I clothe these kids?
Speaker 1 (03:13):
Now?
Speaker 4 (03:14):
Now that's an issue. I feel like.
Speaker 1 (03:16):
We've always had it, and by each generation, how we
manage that, what that looks like, what we call it?
It all looks so different. We're in the thick of
it right now. These are my peers. I'm in it
just like you are. With working full time and as
career women and as moms.
Speaker 4 (03:32):
It is heavy. It feels heavier than it's ever been.
Speaker 2 (03:34):
I think that's the way that everybody feels, to be honest,
and I think that sort of this constant internal dialogue
I think that we experience that we do so much
and it never feels good enough. Yeah, it's a really
painful internal dialogue trying to pay the bills, be successful
in our careers and we're doing morning routines and evening
routines and chauffeuring and keeping the house clean and doing
(03:57):
balanced meals and taking care of ourselves actually sizing and
eating well, and somehow it never feels good enough.
Speaker 1 (04:03):
Yeah.
Speaker 2 (04:03):
With social media as prevalent as it is today, there's
always someone who seems like they're doing it better, and
it's sort of this hyped up version of keeping up
with the Joneses.
Speaker 4 (04:14):
It is all the time.
Speaker 1 (04:15):
It is, it is, it's never ending, and just like
anything in life, there is no pill, there is no
fast fix, there is no just like light switch, turn
it off.
Speaker 4 (04:25):
That's not my struggle. I mean, if there is.
Speaker 1 (04:27):
A woman out there that feels that way, God bless you,
please do a ted talk vanity that is always going
to play a part because in that whole comparison or
I'm never good enough, then we have some of those
old demons. My inner fourteen year old will start to say,
you don't look this way, you're not this size, pay
attention to the number on the scale. I just want
(04:48):
to shut her right up. It's still the world we
live in. We still put those pressures on ourselves. We
know better as well. Because of things like television and
movies and social media, people are always judging other people.
It is a sad mental It is how do we
help ourselves? Well?
Speaker 2 (05:03):
As you were saying that, one of the things that
came to mind is what I tell many of my clients,
as far as you know, can you try to treat
yourself the way that you want your daughter to treat herself? Yeah,
because when we're looking in the mirror thinking our tummies
too round or our thighs are too big, and our
daughters and sons, but especially our little girls, when they
see us doing that, that is in turn the way
(05:24):
that they're going to relate to their bodies. So we
owe it to ourselves, and we also owe it to
our children to really try to be as kind and
loving towards ourselves as we can be, because that sets
a stage for the way that they're going to treat themselves.
Speaker 1 (05:36):
And that it does it does when it comes to
a diet. I've heard experts say this in the past,
that the failure of the diet is that you're only
going to do this for X amount of time and
then it's over.
Speaker 4 (05:48):
But it never really is over.
Speaker 1 (05:50):
As we learn from health experts, what a diet really
should be treated as is a lifestyle. If we're going
to try to improve our health and wellness and we're
doing it by the things that we're putting in our body,
it's an active, daily practice, the same kind of thing
that we do with that inner dialogue with ourselves, but
then outer dialogue of what we're talking about ourselves in
(06:11):
front of others like our kids. It's easier just to
then I've accepted that, I know that's the reality. I
just need to be this way every day. I need
to try to do my best every day.
Speaker 2 (06:21):
And start looking at what we are doing instead of
what we're not doing Ooh, I like that.
Speaker 4 (06:27):
That feels more manageable.
Speaker 1 (06:29):
We could all come up with probably three pages full
of what we're not doing.
Speaker 4 (06:33):
Well and give ourselves credit.
Speaker 2 (06:35):
It's easier to see all those dishes are still in
the sink from last night I failed. Well, what about
the reframe of I spent those fifteen minutes reading a
book to my kids instead? What's really more important? Yes,
rewriting the story that we're telling ourselves and looking at
all the good that we are doing, even if it's
not written on our.
Speaker 4 (06:53):
To do list.
Speaker 1 (06:54):
You did make the meal. Another is a big mess.
You just made your family a meal. You put some
love in that. Everyone's their tummings, our fall. The reframe
can be very, very helpful when it comes to needing
a little bit more. The talk in our head is
more than we can manage. It's manifested into something where
you feel like I've reached an unhealthy place.
Speaker 4 (07:15):
What do we do then?
Speaker 2 (07:16):
That's a great question, and I would even back up
to say that we don't have to wait until it
gets to an unhealthy place.
Speaker 4 (07:21):
I agree, Oh, I do.
Speaker 2 (07:23):
That's something I really encourage people to reach out for support.
I'm a psychologist, so I provide therapy. I think that
everyone could benefit from therapy. And amen, sister, you don't
have to be in crisis. You don't have to have
hit rock bottom. Right, Who wouldn't like a compassionate ear right?
We could all use that. I am a forty five
year old woman. I have almost twenty years sought talk therapy,
(07:43):
help with medication because of where my mental status is,
and I feel so confident and good about that. But
I will tell you in the beginning that was a scary,
scary thing, and twenty years ago felt so much more taboo.
Speaker 4 (07:56):
To ask for this help.
Speaker 1 (07:57):
And maybe it could be our gender, it could be
where we're from, our environment, we're Midwesterners. This seems to
be a little harder to ask for help, but it
really isn't. It's become more and more acceptable to do
just that. And I love that you framed it by
saying before we're in crisis mode, because it is so true.
I think everybody absolutely can benefit from therapy. And you
might even feel like if I've been leaning too much
(08:19):
on my friends and family and I'm not getting an
attentive reaction or response like I used to, it might
be because you are leaning a little too heavily on
those people and they have their.
Speaker 4 (08:31):
Own things going on. I completely agree.
Speaker 2 (08:34):
Yes, it's never a bad time to seek therapy, and
therapy gets kind of a bad rap. You're talking about
some of the stigma and how that fortunately moving in
the right direction. It is right, but therapy isn't what
it's portrayed to be in the movies like that doesn't
do our field any favors whatsoever. Truly is a confidential
place where you can just get a different perspective, not
have to worry about burdening your family members, and also
(08:55):
truthfully probably being helped even more.
Speaker 1 (08:58):
Yeah, we are still putting on a day different mask
with every person in our lives. If it's your sister,
if it's your spouse, if it's your mother, we filter things.
We don't want them to judge us. I've always found
at therapy this is truly where every mask can be.
Speaker 4 (09:12):
Left at the door. This is my safe space.
Speaker 1 (09:14):
Right once you reach that, that helps take a little
bit off of the mental load plate too, to finally
have a safe space. Yes, what does therapy look like?
How would you describe it?
Speaker 2 (09:26):
Kind of joke, because I do have a big lung
couch in my office and sometimes people come in and
they look at the couch and they're like, oh, my goodness,
you know, because that's what you see in the movie
is very freudy and like, come lay down and tell
me your dreams. So I think it really is a respectful,
attentive conversation between two people. One person who's really trained
to listen and validate and help. But it's a lot
(09:49):
of listening, a lot of perspective taking, and a lot of.
Speaker 4 (09:53):
I don't want to say advice.
Speaker 2 (09:54):
I think sometimes people come to therapy looking for advice,
and I don't think a good therapist is going to say, yeah, you.
Speaker 4 (10:00):
Know, go home and do this.
Speaker 2 (10:01):
I would say helping people to sort of arrive at
their own conclusions, maybe by reflecting, guiding people along the
path towards recognizing what it is that they really want
to need, and then empowering them to do that.
Speaker 1 (10:12):
I'm loving everything you're saying because the success that I
have felt in terms of you know, hour spent in
therapy have been just that it's help along the way
to arrive at my own destination. I'm finding maybe conclusions
that still have some questions, but that's life, we might revisit.
Speaker 4 (10:33):
Certain areas or topics.
Speaker 1 (10:34):
Continually being able to have support in a healthy place.
It's undeniably priceless in my mind. Thank you for all
you do for your patients, because genuinely, if you have
not heard that today, you deserve to.
Speaker 4 (10:46):
Hear it so well. Thank you.
Speaker 1 (10:48):
How does a relationship with your PCP get.
Speaker 4 (10:51):
The ball rolling?
Speaker 2 (10:52):
It's probably the best place to start if you are
at that point where you're thinking, I really would like
behavior health services, whether that's medication management or therapy. At
Essentia in particular, all of our behavioral health referrals come
from primary care. So if you're just not really sure
where to start, go talk to your doctor and just
express that you're having some emotional concerns, maybe depression, maybe anxiety,
(11:16):
maybe you're not really sure what's wrong.
Speaker 4 (11:18):
Yeah, the point of.
Speaker 2 (11:19):
Coming in for a consult to sort of help determine
what is going on emotionally, and they can place their
referral and get you hooked up with favoral health.
Speaker 1 (11:27):
When it comes to your behavioral health therapist and your
primary in tandem, especially if it is decided that taking
an oral medication is going to be helpful with whatever
you're dealing with. So you do want a good team
in place. That is what I've found Personally, you want
somebody that you can go and speak with, but also
(11:47):
you want your primary to be on board. They need
to know what's also going on in your life. I
feel like when it comes to managing emotions and stress
and my anxiety and depression, that seems to work the best.
Speaker 2 (11:58):
I completely agree with what you're and I think that
one of the advances maybe that we've made in the
mental health field and in understanding mental health is recognizing
that physical and mental health cannot be separated. Mental health
impacts physical health, physical health impacts mental health. Our bodies
are a whole entity, right, and the more holistic we
can be about that, the healthier we're going to be.
(12:21):
So Yes, if your team consists of people who communicate
and understand and in psychology, it's important to me to
know what is going on physically for my patients, just
as primary care providers are going to be more effective
if they're aware of what's.
Speaker 4 (12:34):
Going on emotionally.
Speaker 1 (12:35):
Totally agree, definitely been on both sides of the coin here,
and you can be working on your mental health and
many coping mechanisms. Then will go back to some sort
of physical element things that have really helped me in
the past, things like grounding and finding a safe space
where I can be in nature. I'm moving my body
doing some physical activity. It's an added bonus or a
side effect is my mental health improves the more I'm
(12:59):
doing those things. And I don't have a step count
I'm looking at or a certain number of things that
I have to have and achieve for me personally is
a little stressful on my mental health. There can be
a space where you're doing great things for your body
physically and great things for your mind emotionally and mentally.
Speaker 2 (13:17):
Yes, As a trauma therapist, one of the things that
I see a lot is physical impact of unprocessed emotional trauma.
Speaker 1 (13:25):
Yes, can you give me some examples well, so, particularly.
Speaker 2 (13:28):
In women who have a lot of chronic illnesses, so fibromyolgia,
irritable bowel syndrome, chronic pain, that sort of thing. Most
of these people who I'm thinking of, they also have
lifetimes of trauma, unprocessed trauma. So there's a book, kind
of a classic in the field called The Body Keeps
the Score. It essentially says that you know, when we
have all of these adverse experiences that have happened to us,
(13:50):
it impacts our physical well being. And so I think
that's just another example. Not everybody has lifetimes of unprocessed trauma,
but any of these emotions, whether it's exact or fear
or sadness or loneliness or abandonment, if we don't deal
with those, it shows up later in our bodies.
Speaker 1 (14:07):
It really, really, truly does. I'm glad you made that recommendation.
I don't think that book has ever been recommended on
this podcast before. A great description. It is very dense,
it is heavy. What I found was great is after
I had had the physical book where I had made annotations, highlighters,
little notes and stuff.
Speaker 4 (14:24):
That I bought the audible book.
Speaker 1 (14:25):
It's one that I revisit because sometimes in a drive
or on a long walk, a reminder the continual work
that is unpacking trauma and doing the trauma work that
if you have it, it goes back to an ongoing
practice really to try to put yourself in the best place.
Do you have anything that you are looking at in
behavioral health that is coming up on the horizon that excites.
Speaker 2 (14:47):
You One of the things that is in practice but
really has become much more commonplace recently, is use of
ketamine for treatment resistant depression. I'm not a psychiatrist, but
certainly my patients who are receiving medication management, who've often
been on several trials of antidepressants and been relatively unsuccessful. Yeah,
some of these people are finding a lot of benefit
(15:07):
from ketamine. And it's pretty exciting because it is available
in Fargo, it's available at our Detroit Lake Facility, and
the people who are trying to have noticed it's really
changing their lives.
Speaker 4 (15:17):
That is very exciting.
Speaker 1 (15:18):
I Unfortunately we have to also deal with media and headlines.
They think one thing, they think, oh no, is this
going to be a highly addictive drug.
Speaker 2 (15:27):
You know. This leads into a really good point just
about what we see on social media. The biggest concern
that I have so far is people coming in and
saying I want to try this because I've seen it,
and not everybody is a good candidate for ketamine. You
do have to have a pretty significant behavioral health history
in order to justify the use of it. For example,
much more excited about the idea of trying ketamine than
(15:47):
doing the trauma work. Those things aren't exchangeable in that way, right, Like,
if you have to do the trauma work, you have
to do the trauma work. So I think sometimes people
come in and they're a little disappointed because they are
may be not great candidates for this the segment of
the population and again who just does not receive benefit
from the typical antidepressant trials.
Speaker 4 (16:04):
Yeah, it's life changing.
Speaker 1 (16:05):
That excites me to know that people are seeing some
real benefits and getting help, especially when they haven't in
the past, like they haven't found anything that works.
Speaker 4 (16:12):
Those are always very exciting.
Speaker 1 (16:14):
I'm glad that you brought that up to because a
little bit that can be a misconception in our happy
to medicate worlds. I think a lot of people just going, oh,
I just went into my doctor and prescribed xyz Okay.
When I hear friends or peers say that to me
they've never saw any kind of therapy, I get nervous.
Cool is this primary person that you're going to that's
(16:36):
already prescribing you and you're happily taking them because maybe
you did see something on TikTok or whatever. I start
to question that a little bit. I think have you
dove deep enough, do some of your trauma work. Have
you tried behavioral health at all and not just treating
maybe some surface symptoms.
Speaker 2 (16:52):
It comes up daily. In my practice we see this
a lot with ADHD. I do psychological testing for ADHD,
and I will say I so appreciate people in primary
care and internal med who will send their patients with
ADHD like symptoms to us foreign evaluation. There are so
many conditions where fidgetiness, loss of attention, focus, concentration, memory concerns.
(17:15):
Those crop up across several different diagnoses. That can be
the case if you have anxiety or depression or ADHD
or trauma, and the only real way to differentiate what
is actually happening is to go through the steps of
an evaluation. I think it's very tempting, probably, and most
patients want it to just be handed a prescription. Adderall
(17:35):
or Riddlin will help most people concentrate even if you
don't have ADHD.
Speaker 4 (17:40):
Yes, yes, but it's not the best.
Speaker 2 (17:42):
Treatment if someone actually has anxiety or has trauma.
Speaker 4 (17:45):
Instead.
Speaker 2 (17:46):
So I think asking the questions, jumping through the hoops
of getting the true diagnosis is best practice, and so
I always encourage you my colleagues please send patients our
way and we can determine what's really going on prior
to starting a medication. Truly what's best for the individualtead
of just masking. Just because you can focus doesn't mean
that you're healed.
Speaker 4 (18:04):
So true.
Speaker 1 (18:05):
I feel especially protective when it comes to behavioral health
and finding the right diagnosis, especially when you're determining medication
or no medication, and the management of all of that
with our children. Having one of my kids go through
exactly this, get an ADHD diagnosis very early on, and
finding the right providers in therapy as well as primary
(18:29):
who work really well together and are willing to take
the time and effort that it takes in finding the
right thing that works. I want my child to, of
course be healthy and get the best out of life.
Speaker 4 (18:43):
You want the right thing for your kids.
Speaker 2 (18:45):
Yes, it's never a one size fits all approach. No,
every kid is different. Everyone's going to respond differently to
a medication, everybody's going to respond differently to a provider.
What you're saying about provider fit is real. There are
a lot of good doctors, good therapists who aren't going
to be the right doctor or right therapist for everybody.
So it's also feeling empowered as parents to say, you
(19:06):
know what, my child doesn't seem to be responding well,
or this doesn't make me feel really comfortable in finding
someone else.
Speaker 1 (19:12):
Yeah, a team that's willing to work with me to
find the right fit for me and for my kids.
And we are in it. We're in it to win it,
and we all just need to give ourselves some grace.
Speaker 2 (19:22):
I think I use that phrase at least three times
a day every day.
Speaker 4 (19:26):
Give yourself some grace.
Speaker 2 (19:28):
Yes, there's no manual how to do life, how to
be a perfect parent. Everybody has opinions, everybody has ideas, right,
but ultimately we're each the own expert on our lives,
and nobody knows your kids as well as you do.
Nobody knows my kids as well as I do. So
feeling empowered to speak up on their behalf and on
our behalves. Just because someone's a professional doesn't mean they
(19:49):
have all the answers, and so really trust your gut.
Speaker 1 (19:51):
Great advice. Perfection doesn't exist for us. At best, we
can hope for some progress social media trends. You kind
of dabbled into ADHD right now, what I'm seeing on
TikTok and Instagram and other social media platforms. Also seeing
this in advertising as well, not only out of the woodwork.
It feels like women are being diagnosed with ADHD. Feels
(20:13):
like an influx. Is that in my head or is
that something that's actually happening.
Speaker 2 (20:17):
I definitely have seen an increase in that, and I
think it feels a little reactive to the fact that
this was historically diagnosed more in males. ADHD tends to
look very different in girls and boys.
Speaker 4 (20:29):
In men and women.
Speaker 2 (20:30):
Generally speaking, boys tend to be more of the like
hyperactive type, while girls tend to be more inattentive, and
in the classroom setting, it's not hard to tell which
one of those is more easily identified. Right, hyperactive behaviors
tend to be more disruptive, so they're the ones that
are flagged. So it almost feels like a rebound effect
to like women can have ADHD too, And yes, women
(20:51):
can have ADHD. The hallmark symptoms of ADHD may indicate ADHD,
they may not. And you know, as difficult as it
is sometimes to have people come in and say I.
Speaker 4 (21:01):
Have ADHD, I need treatment for that, and.
Speaker 2 (21:03):
Then having to back up and maybe say, actually, it's
not the thing that I appreciate about this trend is
that it's.
Speaker 4 (21:09):
Getting people in the door.
Speaker 2 (21:10):
Yes, and it's opening up the dialogue, breaking down the
stigma because if we see it in other people, if
we see it on TikTok, if we see it on Facebook, Instagram,
it's making it more permissible to talk about it.
Speaker 4 (21:22):
Sure, and that's a start. That's a positive.
Speaker 1 (21:25):
Not only are there books out there basically helping you
self diagnose, but there are apps that promise the same
that they're just going to be able to diagnose you.
And I realize I might be a little biased here
because I am so pro go to experts. Is there
any validity to that?
Speaker 2 (21:43):
I don't think that any of those tools are going
to replicate the work of a trained professional. I personally
am not dove into any of the apps, so I
don't know how comprehensive some of them are. But I
would say that that sounds like a band aid fix
sort of. These quizzes that you can take.
Speaker 1 (22:01):
They might not even be trying to get you on
a medication, but sign up for this app, do.
Speaker 4 (22:06):
You even have an actual diagnose?
Speaker 2 (22:08):
Right?
Speaker 1 (22:08):
Or right? You just downloaded another app and you're giving
nineteen ninety nine a month to it.
Speaker 2 (22:13):
My nutshell advice about that would be probably to be
used for entertainment purposes only. I mean, if people find
that fun, I think that that's fine. No, I don't
think that you can replace going in and truly the
evaluation process for ADHD in particular, because it is a
neuropsychological disorder, like there are actual differences in people's brains
(22:33):
that can only be done by a trained professional, and
it's a fairly rigorous process for a reason. If we
didn't have to go through this multiple hour process, we wouldn't,
but there's a reason for it.
Speaker 1 (22:44):
So yeah, and it can definitely take a very long time.
Here's what you should do if you feel like you
have something going on.
Speaker 2 (22:52):
A great place to start, as we had already talked about,
is making an appointment with your primary asking for a referral.
At Essentia primary Care will do internal referrals to behavioral
health and get you set up with a consult To
really view the consult as exactly that you're going to
sit down for an hour with someone who can help
you determine what's likely going on and help hook you
(23:12):
up with other services, whether that's medication, or you need
a higher level of care, or you need a referral
elsewhere for some reason. You know, just starting there to
figure out you know, that's the first step and sort
of the gateway into what comes next.
Speaker 1 (23:27):
And this even before you're sitting down with somebody and
having that initial conversation, you've already done quite a bit
of backwork in that they have got a lot of
questionnaires for you to fill out. There's a lot of
paperwork going into behavioral health for good reason, because you're
coming in fresh with somebody to have a conversation. It's
not a fix that is just like this is happening today.
(23:48):
You're starting this today, and it's a journey.
Speaker 4 (23:51):
I agree, and I think too. You know, if at
any point that.
Speaker 2 (23:54):
Feels or sounds overwhelming to someone, I would argue that
the hardest part is probably done. Picking up the phone
and making that initial appointment is probably the hardest part.
To acknowledge that you could use some additional support, and
then to have the courage to actually set the ball
in motion. Yes, there are more steps to come, but
I would say, again give yourself credit for the fact
(24:14):
that you've started the conversation, and once you found that
right person, it does get easier.
Speaker 4 (24:19):
It's very rewarding.
Speaker 2 (24:20):
And I think that with the right professional and targeting
the right things, it's actually going to be very rewarding
very quickly.
Speaker 1 (24:27):
Thank you for that. We do actually need a little affirmation.
That was a good job. You made an appointment today.
Keep the appointment. That's also another step that can be
very challenging. Keep the appointment to go and then move
on to the next step. What are we hoping for
the best balance of our mental health?
Speaker 4 (24:44):
Number One, to be happy?
Speaker 2 (24:46):
You know, in day to day life, Yes, I'm fine,
things are good, everything's fine.
Speaker 4 (24:51):
How many of us are really happy? Sure?
Speaker 2 (24:53):
I would guess that the percentage is far lower than
it appears. I think a reduction and anxiety, reduction in
rigid high standards and the need to compare, fewer thoughts
about not being good enough or somehow failing.
Speaker 4 (25:08):
These are sort of universal.
Speaker 2 (25:09):
I can't think of a single person who I work
with in my practice that those don't apply to, you know,
and if we could take all of those things and
really exercise them on a daily basis, we would be happy.
That's where it is for me. You know, find things
that are fulfilling and meaningful. Get joy out of the
truly important things, like spending time with your kids instead
of feeling like you have to do the dishes or
(25:30):
vacuum or make more money.
Speaker 4 (25:32):
You know, slow down, be still. Boy, isn't that a
challenge for most of us?
Speaker 1 (25:38):
Just taking some time where we don't need to have
a screen in front of our face all the time.
Speaker 4 (25:44):
We don't need to have noise all the time.
Speaker 1 (25:47):
We can actually just take a moment for ourselves and
just be And that's okay, not always having to have
a stimulation. It might be beneficial to you. I repackage
that as a daily check. And for myself, don't ask
myself am I happy? I ask myself if I have
joy in my life, because for me, happiness can be fleeting.
(26:08):
There's going to be a bad day and some days
there doesn't feel like there's any happiness. But I can
still find joy even in those really crappy, crummy days.
And it's what my kids are doing well and I
get to see them today, simple as that. Or go
back to the dinner thing. Everybody ate a meal and
their tummies are fallen. We're in a warmhouse. Today it
feels like everything else is falling apart. But these are
(26:30):
the things I can focus on, and I know that
I have them, and that gives me joy. How you
look at it, where you put value, I think might
be one of the most important things you can do
for yourself. Yes, yes, everybody's watching, and by that I
mean your kids, your spouse, your partner, the people that
whose opinions you might want to put more value in
(26:52):
instead of the rest of the world and people on
the internet.
Speaker 2 (26:54):
What did doctors say, those who mine don't matter and
those who matter don't mind?
Speaker 1 (26:59):
Oh?
Speaker 4 (26:59):
Yes, right, thanks a good mantras. It really is.
Speaker 1 (27:02):
A good mantra. We go back to some of those
that are just like there was a reason why this
was so catchy. Doctor Cole Hayes, you have been outstanding.
Thank you for being such a great guest today. I've
really enjoyed this conversation and appreciate you so much. Thanks
for all that you're doing with your practice. Behavioral health
is Sentia Health. She's been there for the last four years.
(27:22):
And are you taking new patients?
Speaker 4 (27:25):
Yes? Absolutely, Okay.
Speaker 1 (27:27):
Essentia health dot Org can look up doctor Alexandra Colehes
or any of her other partners over in the behavioral
health department. Thank you so much for coming in.
Speaker 4 (27:36):
Thank you for having me Corey.
Speaker 1 (27:39):
Just having that conversation with doctor Cole Hayes lightened my
mental load. Something to be said about being able to
talk out whatever is going on inside your mind.
Speaker 4 (27:51):
That alone can help lighten the load a little bit.
Speaker 1 (27:53):
On the next Dare to Ask podcast, we go back
into the world of weight management. Think about how many
ways things like semiglue tithes have changed just over the
last year. If they're right for you, or maybe this
is exactly the thing that's going to be perfect for
you to reach your goals and get to a healthy weight.
That's upcoming on the next Dare to Ask podcast episode.
Speaker 3 (28:16):
The information contained in this podcast is not intended to
be a substitute for personalized professional medical advice, diagnosis, or treatment.
The information is general in nature. If you have questions
or concerns, please contact your provider.
It's never a bad time to seek therapy with doctor
Alexandria Colhais.
Speaker 2 (00:04):
Whether it's anxiety or fear, or sadness, loneliness or abandonment.
If we don't deal with those, it shows up later
in our bodies.
Speaker 1 (00:12):
I'm Corey Jensen, your host for the Dare to Ask podcast,
a space created by women for women who want to
stay informed about their health issues as well as the
wellness of their kids. We've designed this to be a
casual conversation with real health experts to help us understand
our bodies, advocate for our care, and prepare ourselves to
have the conversation with our providers without feeling intimidated. A
(00:35):
place to talk like girlfriends do. A space that dares.
Speaker 2 (00:38):
To ask, constant internal dialogue. I think that we experience
that we do so much and it never feels good enough.
Speaker 3 (00:43):
We're here to make a connection. You've landed on the
Dare to Ask podcast show hosted by Corey Jensen and
sponsored by is Sanha Health.
Speaker 2 (00:52):
I'm a psychologist, so I provide therapy. I think that
everyone could benefit from therapy. You don't have to have
hit rock bottom. Who wouldn't like a compassionate ear we
could all use.
Speaker 1 (01:00):
That mental load. She can be a heavy one, and
when it comes to us women, the mental load that
we carry seems to be not only heavy, but fraught
with a whole lot of self imposed standards that we
attempt to hold ourselves to, and that adds to the heaviness.
I'm excited to have doctor Alexandra Colehayes. She is a
(01:23):
behavioral health psychologist. It's our inner dialogue, it's our voice
that seems to lead the charge in a lot of
our mental load, and she comes up with some great
ways for us to help reframe that so that we
can celebrate more of our successes rather than just be
looking and focusing on our perceived failures. We'll talk about
(01:44):
how to get started seeking therapy and that relationship between
physical and mental health. We're going to talk about the
role medication and talk therapy and ways we can manage
mental health conditions, including conditions like ADHD and how women
are being diagnosed with that more and more. We really
have a lot to unpack here, so let's get to
(02:05):
it as we dip our toes into the behavioral health field.
I thank you so much for coming in and being
a guest on this season. We are now in season
five of the dar to Ask podcast. We have successfully
been talking about women's health issues and our children's health
issues for five years now. Further way to dive deeper
into topics and the mental load, How would you describe
(02:29):
what that means for women? We could all have our
own definition.
Speaker 4 (02:33):
Yes, I would agree with that.
Speaker 2 (02:35):
I think it really is a very apt descriptor to
call it a mental load, because it's heavy. It's the
weight of all of the expectations that we place on
ourselves decietally, what's expected of us. The more women and
mothers I talk to doing the work that I do,
so much of it is a self imposed rules standards,
the very high pressure that we always have on ourselves.
(02:58):
And as a mom and a psychologist, I understand that
trying to balance the many obligations and trying to wear
so many hats at one time all the time.
Speaker 1 (03:06):
Don't you feel like it's always been the fate of
women generationally?
Speaker 4 (03:11):
Eve was getting how do I clothe these kids?
Speaker 1 (03:13):
Now?
Speaker 4 (03:14):
Now that's an issue. I feel like.
Speaker 1 (03:16):
We've always had it, and by each generation, how we
manage that, what that looks like, what we call it?
It all looks so different. We're in the thick of
it right now. These are my peers. I'm in it
just like you are. With working full time and as
career women and as moms.
Speaker 4 (03:32):
It is heavy. It feels heavier than it's ever been.
Speaker 2 (03:34):
I think that's the way that everybody feels, to be honest,
and I think that sort of this constant internal dialogue
I think that we experience that we do so much
and it never feels good enough. Yeah, it's a really
painful internal dialogue trying to pay the bills, be successful
in our careers and we're doing morning routines and evening
routines and chauffeuring and keeping the house clean and doing
(03:57):
balanced meals and taking care of ourselves actually sizing and
eating well, and somehow it never feels good enough.
Speaker 1 (04:03):
Yeah.
Speaker 2 (04:03):
With social media as prevalent as it is today, there's
always someone who seems like they're doing it better, and
it's sort of this hyped up version of keeping up
with the Joneses.
Speaker 4 (04:14):
It is all the time.
Speaker 1 (04:15):
It is, it is, it's never ending, and just like
anything in life, there is no pill, there is no
fast fix, there is no just like light switch, turn
it off.
Speaker 4 (04:25):
That's not my struggle. I mean, if there is.
Speaker 1 (04:27):
A woman out there that feels that way, God bless you,
please do a ted talk vanity that is always going
to play a part because in that whole comparison or
I'm never good enough, then we have some of those
old demons. My inner fourteen year old will start to say,
you don't look this way, you're not this size, pay
attention to the number on the scale. I just want
(04:48):
to shut her right up. It's still the world we
live in. We still put those pressures on ourselves. We
know better as well. Because of things like television and
movies and social media, people are always judging other people.
It is a sad mental It is how do we
help ourselves? Well?
Speaker 2 (05:03):
As you were saying that, one of the things that
came to mind is what I tell many of my clients,
as far as you know, can you try to treat
yourself the way that you want your daughter to treat herself? Yeah,
because when we're looking in the mirror thinking our tummies
too round or our thighs are too big, and our
daughters and sons, but especially our little girls, when they
see us doing that, that is in turn the way
(05:24):
that they're going to relate to their bodies. So we
owe it to ourselves, and we also owe it to
our children to really try to be as kind and
loving towards ourselves as we can be, because that sets
a stage for the way that they're going to treat themselves.
Speaker 1 (05:36):
And that it does it does when it comes to
a diet. I've heard experts say this in the past,
that the failure of the diet is that you're only
going to do this for X amount of time and
then it's over.
Speaker 4 (05:48):
But it never really is over.
Speaker 1 (05:50):
As we learn from health experts, what a diet really
should be treated as is a lifestyle. If we're going
to try to improve our health and wellness and we're
doing it by the things that we're putting in our body,
it's an active, daily practice, the same kind of thing
that we do with that inner dialogue with ourselves, but
then outer dialogue of what we're talking about ourselves in
(06:11):
front of others like our kids. It's easier just to
then I've accepted that, I know that's the reality. I
just need to be this way every day. I need
to try to do my best every day.
Speaker 2 (06:21):
And start looking at what we are doing instead of
what we're not doing Ooh, I like that.
Speaker 4 (06:27):
That feels more manageable.
Speaker 1 (06:29):
We could all come up with probably three pages full
of what we're not doing.
Speaker 4 (06:33):
Well and give ourselves credit.
Speaker 2 (06:35):
It's easier to see all those dishes are still in
the sink from last night I failed. Well, what about
the reframe of I spent those fifteen minutes reading a
book to my kids instead? What's really more important? Yes,
rewriting the story that we're telling ourselves and looking at
all the good that we are doing, even if it's
not written on our.
Speaker 4 (06:53):
To do list.
Speaker 1 (06:54):
You did make the meal. Another is a big mess.
You just made your family a meal. You put some
love in that. Everyone's their tummings, our fall. The reframe
can be very, very helpful when it comes to needing
a little bit more. The talk in our head is
more than we can manage. It's manifested into something where
you feel like I've reached an unhealthy place.
Speaker 4 (07:15):
What do we do then?
Speaker 2 (07:16):
That's a great question, and I would even back up
to say that we don't have to wait until it
gets to an unhealthy place.
Speaker 4 (07:21):
I agree, Oh, I do.
Speaker 2 (07:23):
That's something I really encourage people to reach out for support.
I'm a psychologist, so I provide therapy. I think that
everyone could benefit from therapy. And amen, sister, you don't
have to be in crisis. You don't have to have
hit rock bottom. Right, Who wouldn't like a compassionate ear right?
We could all use that. I am a forty five
year old woman. I have almost twenty years sought talk therapy,
(07:43):
help with medication because of where my mental status is,
and I feel so confident and good about that. But
I will tell you in the beginning that was a scary,
scary thing, and twenty years ago felt so much more taboo.
Speaker 4 (07:56):
To ask for this help.
Speaker 1 (07:57):
And maybe it could be our gender, it could be
where we're from, our environment, we're Midwesterners. This seems to
be a little harder to ask for help, but it
really isn't. It's become more and more acceptable to do
just that. And I love that you framed it by
saying before we're in crisis mode, because it is so true.
I think everybody absolutely can benefit from therapy. And you
might even feel like if I've been leaning too much
(08:19):
on my friends and family and I'm not getting an
attentive reaction or response like I used to, it might
be because you are leaning a little too heavily on
those people and they have their.
Speaker 4 (08:31):
Own things going on. I completely agree.
Speaker 2 (08:34):
Yes, it's never a bad time to seek therapy, and
therapy gets kind of a bad rap. You're talking about
some of the stigma and how that fortunately moving in
the right direction. It is right, but therapy isn't what
it's portrayed to be in the movies like that doesn't
do our field any favors whatsoever. Truly is a confidential
place where you can just get a different perspective, not
have to worry about burdening your family members, and also
(08:55):
truthfully probably being helped even more.
Speaker 1 (08:58):
Yeah, we are still putting on a day different mask
with every person in our lives. If it's your sister,
if it's your spouse, if it's your mother, we filter things.
We don't want them to judge us. I've always found
at therapy this is truly where every mask can be.
Speaker 4 (09:12):
Left at the door. This is my safe space.
Speaker 1 (09:14):
Right once you reach that, that helps take a little
bit off of the mental load plate too, to finally
have a safe space. Yes, what does therapy look like?
How would you describe it?
Speaker 2 (09:26):
Kind of joke, because I do have a big lung
couch in my office and sometimes people come in and
they look at the couch and they're like, oh, my goodness,
you know, because that's what you see in the movie
is very freudy and like, come lay down and tell
me your dreams. So I think it really is a respectful,
attentive conversation between two people. One person who's really trained
to listen and validate and help. But it's a lot
(09:49):
of listening, a lot of perspective taking, and a lot of.
Speaker 4 (09:53):
I don't want to say advice.
Speaker 2 (09:54):
I think sometimes people come to therapy looking for advice,
and I don't think a good therapist is going to say, yeah, you.
Speaker 4 (10:00):
Know, go home and do this.
Speaker 2 (10:01):
I would say helping people to sort of arrive at
their own conclusions, maybe by reflecting, guiding people along the
path towards recognizing what it is that they really want
to need, and then empowering them to do that.
Speaker 1 (10:12):
I'm loving everything you're saying because the success that I
have felt in terms of you know, hour spent in
therapy have been just that it's help along the way
to arrive at my own destination. I'm finding maybe conclusions
that still have some questions, but that's life, we might revisit.
Speaker 4 (10:33):
Certain areas or topics.
Speaker 1 (10:34):
Continually being able to have support in a healthy place.
It's undeniably priceless in my mind. Thank you for all
you do for your patients, because genuinely, if you have
not heard that today, you deserve to.
Speaker 4 (10:46):
Hear it so well. Thank you.
Speaker 1 (10:48):
How does a relationship with your PCP get.
Speaker 4 (10:51):
The ball rolling?
Speaker 2 (10:52):
It's probably the best place to start if you are
at that point where you're thinking, I really would like
behavior health services, whether that's medication management or therapy. At
Essentia in particular, all of our behavioral health referrals come
from primary care. So if you're just not really sure
where to start, go talk to your doctor and just
express that you're having some emotional concerns, maybe depression, maybe anxiety,
(11:16):
maybe you're not really sure what's wrong.
Speaker 4 (11:18):
Yeah, the point of.
Speaker 2 (11:19):
Coming in for a consult to sort of help determine
what is going on emotionally, and they can place their
referral and get you hooked up with favoral health.
Speaker 1 (11:27):
When it comes to your behavioral health therapist and your
primary in tandem, especially if it is decided that taking
an oral medication is going to be helpful with whatever
you're dealing with. So you do want a good team
in place. That is what I've found Personally, you want
somebody that you can go and speak with, but also
(11:47):
you want your primary to be on board. They need
to know what's also going on in your life. I
feel like when it comes to managing emotions and stress
and my anxiety and depression, that seems to work the best.
Speaker 2 (11:58):
I completely agree with what you're and I think that
one of the advances maybe that we've made in the
mental health field and in understanding mental health is recognizing
that physical and mental health cannot be separated. Mental health
impacts physical health, physical health impacts mental health. Our bodies
are a whole entity, right, and the more holistic we
can be about that, the healthier we're going to be.
(12:21):
So Yes, if your team consists of people who communicate
and understand and in psychology, it's important to me to
know what is going on physically for my patients, just
as primary care providers are going to be more effective
if they're aware of what's.
Speaker 4 (12:34):
Going on emotionally.
Speaker 1 (12:35):
Totally agree, definitely been on both sides of the coin here,
and you can be working on your mental health and
many coping mechanisms. Then will go back to some sort
of physical element things that have really helped me in
the past, things like grounding and finding a safe space
where I can be in nature. I'm moving my body
doing some physical activity. It's an added bonus or a
side effect is my mental health improves the more I'm
(12:59):
doing those things. And I don't have a step count
I'm looking at or a certain number of things that
I have to have and achieve for me personally is
a little stressful on my mental health. There can be
a space where you're doing great things for your body
physically and great things for your mind emotionally and mentally.
Speaker 2 (13:17):
Yes, As a trauma therapist, one of the things that
I see a lot is physical impact of unprocessed emotional trauma.
Speaker 1 (13:25):
Yes, can you give me some examples well, so, particularly.
Speaker 2 (13:28):
In women who have a lot of chronic illnesses, so fibromyolgia,
irritable bowel syndrome, chronic pain, that sort of thing. Most
of these people who I'm thinking of, they also have
lifetimes of trauma, unprocessed trauma. So there's a book, kind
of a classic in the field called The Body Keeps
the Score. It essentially says that you know, when we
have all of these adverse experiences that have happened to us,
(13:50):
it impacts our physical well being. And so I think
that's just another example. Not everybody has lifetimes of unprocessed trauma,
but any of these emotions, whether it's exact or fear
or sadness or loneliness or abandonment, if we don't deal
with those, it shows up later in our bodies.
Speaker 1 (14:07):
It really, really, truly does. I'm glad you made that recommendation.
I don't think that book has ever been recommended on
this podcast before. A great description. It is very dense,
it is heavy. What I found was great is after
I had had the physical book where I had made annotations, highlighters,
little notes and stuff.
Speaker 4 (14:24):
That I bought the audible book.
Speaker 1 (14:25):
It's one that I revisit because sometimes in a drive
or on a long walk, a reminder the continual work
that is unpacking trauma and doing the trauma work that
if you have it, it goes back to an ongoing
practice really to try to put yourself in the best place.
Do you have anything that you are looking at in
behavioral health that is coming up on the horizon that excites.
Speaker 2 (14:47):
You One of the things that is in practice but
really has become much more commonplace recently, is use of
ketamine for treatment resistant depression. I'm not a psychiatrist, but
certainly my patients who are receiving medication management, who've often
been on several trials of antidepressants and been relatively unsuccessful. Yeah,
some of these people are finding a lot of benefit
(15:07):
from ketamine. And it's pretty exciting because it is available
in Fargo, it's available at our Detroit Lake Facility, and
the people who are trying to have noticed it's really
changing their lives.
Speaker 4 (15:17):
That is very exciting.
Speaker 1 (15:18):
I Unfortunately we have to also deal with media and headlines.
They think one thing, they think, oh no, is this
going to be a highly addictive drug.
Speaker 2 (15:27):
You know. This leads into a really good point just
about what we see on social media. The biggest concern
that I have so far is people coming in and
saying I want to try this because I've seen it,
and not everybody is a good candidate for ketamine. You
do have to have a pretty significant behavioral health history
in order to justify the use of it. For example,
much more excited about the idea of trying ketamine than
(15:47):
doing the trauma work. Those things aren't exchangeable in that way, right, Like,
if you have to do the trauma work, you have
to do the trauma work. So I think sometimes people
come in and they're a little disappointed because they are
may be not great candidates for this the segment of
the population and again who just does not receive benefit
from the typical antidepressant trials.
Speaker 4 (16:04):
Yeah, it's life changing.
Speaker 1 (16:05):
That excites me to know that people are seeing some
real benefits and getting help, especially when they haven't in
the past, like they haven't found anything that works.
Speaker 4 (16:12):
Those are always very exciting.
Speaker 1 (16:14):
I'm glad that you brought that up to because a
little bit that can be a misconception in our happy
to medicate worlds. I think a lot of people just going, oh,
I just went into my doctor and prescribed xyz Okay.
When I hear friends or peers say that to me
they've never saw any kind of therapy, I get nervous.
Cool is this primary person that you're going to that's
(16:36):
already prescribing you and you're happily taking them because maybe
you did see something on TikTok or whatever. I start
to question that a little bit. I think have you
dove deep enough, do some of your trauma work. Have
you tried behavioral health at all and not just treating
maybe some surface symptoms.
Speaker 2 (16:52):
It comes up daily. In my practice we see this
a lot with ADHD. I do psychological testing for ADHD,
and I will say I so appreciate people in primary
care and internal med who will send their patients with
ADHD like symptoms to us foreign evaluation. There are so
many conditions where fidgetiness, loss of attention, focus, concentration, memory concerns.
(17:15):
Those crop up across several different diagnoses. That can be
the case if you have anxiety or depression or ADHD
or trauma, and the only real way to differentiate what
is actually happening is to go through the steps of
an evaluation. I think it's very tempting, probably, and most
patients want it to just be handed a prescription. Adderall
(17:35):
or Riddlin will help most people concentrate even if you
don't have ADHD.
Speaker 4 (17:40):
Yes, yes, but it's not the best.
Speaker 2 (17:42):
Treatment if someone actually has anxiety or has trauma.
Speaker 4 (17:45):
Instead.
Speaker 2 (17:46):
So I think asking the questions, jumping through the hoops
of getting the true diagnosis is best practice, and so
I always encourage you my colleagues please send patients our
way and we can determine what's really going on prior
to starting a medication. Truly what's best for the individualtead
of just masking. Just because you can focus doesn't mean
that you're healed.
Speaker 4 (18:04):
So true.
Speaker 1 (18:05):
I feel especially protective when it comes to behavioral health
and finding the right diagnosis, especially when you're determining medication
or no medication, and the management of all of that
with our children. Having one of my kids go through
exactly this, get an ADHD diagnosis very early on, and
finding the right providers in therapy as well as primary
(18:29):
who work really well together and are willing to take
the time and effort that it takes in finding the
right thing that works. I want my child to, of
course be healthy and get the best out of life.
Speaker 4 (18:43):
You want the right thing for your kids.
Speaker 2 (18:45):
Yes, it's never a one size fits all approach. No,
every kid is different. Everyone's going to respond differently to
a medication, everybody's going to respond differently to a provider.
What you're saying about provider fit is real. There are
a lot of good doctors, good therapists who aren't going
to be the right doctor or right therapist for everybody.
So it's also feeling empowered as parents to say, you
(19:06):
know what, my child doesn't seem to be responding well,
or this doesn't make me feel really comfortable in finding
someone else.
Speaker 1 (19:12):
Yeah, a team that's willing to work with me to
find the right fit for me and for my kids.
And we are in it. We're in it to win it,
and we all just need to give ourselves some grace.
Speaker 2 (19:22):
I think I use that phrase at least three times
a day every day.
Speaker 4 (19:26):
Give yourself some grace.
Speaker 2 (19:28):
Yes, there's no manual how to do life, how to
be a perfect parent. Everybody has opinions, everybody has ideas, right,
but ultimately we're each the own expert on our lives,
and nobody knows your kids as well as you do.
Nobody knows my kids as well as I do. So
feeling empowered to speak up on their behalf and on
our behalves. Just because someone's a professional doesn't mean they
(19:49):
have all the answers, and so really trust your gut.
Speaker 1 (19:51):
Great advice. Perfection doesn't exist for us. At best, we
can hope for some progress social media trends. You kind
of dabbled into ADHD right now, what I'm seeing on
TikTok and Instagram and other social media platforms. Also seeing
this in advertising as well, not only out of the woodwork.
It feels like women are being diagnosed with ADHD. Feels
(20:13):
like an influx. Is that in my head or is
that something that's actually happening.
Speaker 2 (20:17):
I definitely have seen an increase in that, and I
think it feels a little reactive to the fact that
this was historically diagnosed more in males. ADHD tends to
look very different in girls and boys.
Speaker 4 (20:29):
In men and women.
Speaker 2 (20:30):
Generally speaking, boys tend to be more of the like
hyperactive type, while girls tend to be more inattentive, and
in the classroom setting, it's not hard to tell which
one of those is more easily identified. Right, hyperactive behaviors
tend to be more disruptive, so they're the ones that
are flagged. So it almost feels like a rebound effect
to like women can have ADHD too, And yes, women
(20:51):
can have ADHD. The hallmark symptoms of ADHD may indicate ADHD,
they may not. And you know, as difficult as it
is sometimes to have people come in and say I.
Speaker 4 (21:01):
Have ADHD, I need treatment for that, and.
Speaker 2 (21:03):
Then having to back up and maybe say, actually, it's
not the thing that I appreciate about this trend is
that it's.
Speaker 4 (21:09):
Getting people in the door.
Speaker 2 (21:10):
Yes, and it's opening up the dialogue, breaking down the
stigma because if we see it in other people, if
we see it on TikTok, if we see it on Facebook, Instagram,
it's making it more permissible to talk about it.
Speaker 4 (21:22):
Sure, and that's a start. That's a positive.
Speaker 1 (21:25):
Not only are there books out there basically helping you
self diagnose, but there are apps that promise the same
that they're just going to be able to diagnose you.
And I realize I might be a little biased here
because I am so pro go to experts. Is there
any validity to that?
Speaker 2 (21:43):
I don't think that any of those tools are going
to replicate the work of a trained professional. I personally
am not dove into any of the apps, so I
don't know how comprehensive some of them are. But I
would say that that sounds like a band aid fix
sort of. These quizzes that you can take.
Speaker 1 (22:01):
They might not even be trying to get you on
a medication, but sign up for this app, do.
Speaker 4 (22:06):
You even have an actual diagnose?
Speaker 2 (22:08):
Right?
Speaker 1 (22:08):
Or right? You just downloaded another app and you're giving
nineteen ninety nine a month to it.
Speaker 2 (22:13):
My nutshell advice about that would be probably to be
used for entertainment purposes only. I mean, if people find
that fun, I think that that's fine. No, I don't
think that you can replace going in and truly the
evaluation process for ADHD in particular, because it is a
neuropsychological disorder, like there are actual differences in people's brains
(22:33):
that can only be done by a trained professional, and
it's a fairly rigorous process for a reason. If we
didn't have to go through this multiple hour process, we wouldn't,
but there's a reason for it.
Speaker 1 (22:44):
So yeah, and it can definitely take a very long time.
Here's what you should do if you feel like you
have something going on.
Speaker 2 (22:52):
A great place to start, as we had already talked about,
is making an appointment with your primary asking for a referral.
At Essentia primary Care will do internal referrals to behavioral
health and get you set up with a consult To
really view the consult as exactly that you're going to
sit down for an hour with someone who can help
you determine what's likely going on and help hook you
(23:12):
up with other services, whether that's medication, or you need
a higher level of care, or you need a referral
elsewhere for some reason. You know, just starting there to
figure out you know, that's the first step and sort
of the gateway into what comes next.
Speaker 1 (23:27):
And this even before you're sitting down with somebody and
having that initial conversation, you've already done quite a bit
of backwork in that they have got a lot of
questionnaires for you to fill out. There's a lot of
paperwork going into behavioral health for good reason, because you're
coming in fresh with somebody to have a conversation. It's
not a fix that is just like this is happening today.
(23:48):
You're starting this today, and it's a journey.
Speaker 4 (23:51):
I agree, and I think too. You know, if at
any point that.
Speaker 2 (23:54):
Feels or sounds overwhelming to someone, I would argue that
the hardest part is probably done. Picking up the phone
and making that initial appointment is probably the hardest part.
To acknowledge that you could use some additional support, and
then to have the courage to actually set the ball
in motion. Yes, there are more steps to come, but
I would say, again give yourself credit for the fact
(24:14):
that you've started the conversation, and once you found that
right person, it does get easier.
Speaker 4 (24:19):
It's very rewarding.
Speaker 2 (24:20):
And I think that with the right professional and targeting
the right things, it's actually going to be very rewarding
very quickly.
Speaker 1 (24:27):
Thank you for that. We do actually need a little affirmation.
That was a good job. You made an appointment today.
Keep the appointment. That's also another step that can be
very challenging. Keep the appointment to go and then move
on to the next step. What are we hoping for
the best balance of our mental health?
Speaker 4 (24:44):
Number One, to be happy?
Speaker 2 (24:46):
You know, in day to day life, Yes, I'm fine,
things are good, everything's fine.
Speaker 4 (24:51):
How many of us are really happy? Sure?
Speaker 2 (24:53):
I would guess that the percentage is far lower than
it appears. I think a reduction and anxiety, reduction in
rigid high standards and the need to compare, fewer thoughts
about not being good enough or somehow failing.
Speaker 4 (25:08):
These are sort of universal.
Speaker 2 (25:09):
I can't think of a single person who I work
with in my practice that those don't apply to, you know,
and if we could take all of those things and
really exercise them on a daily basis, we would be happy.
That's where it is for me. You know, find things
that are fulfilling and meaningful. Get joy out of the
truly important things, like spending time with your kids instead
of feeling like you have to do the dishes or
(25:30):
vacuum or make more money.
Speaker 4 (25:32):
You know, slow down, be still. Boy, isn't that a
challenge for most of us?
Speaker 1 (25:38):
Just taking some time where we don't need to have
a screen in front of our face all the time.
Speaker 4 (25:44):
We don't need to have noise all the time.
Speaker 1 (25:47):
We can actually just take a moment for ourselves and
just be And that's okay, not always having to have
a stimulation. It might be beneficial to you. I repackage
that as a daily check. And for myself, don't ask
myself am I happy? I ask myself if I have
joy in my life, because for me, happiness can be fleeting.
(26:08):
There's going to be a bad day and some days
there doesn't feel like there's any happiness. But I can
still find joy even in those really crappy, crummy days.
And it's what my kids are doing well and I
get to see them today, simple as that. Or go
back to the dinner thing. Everybody ate a meal and
their tummies are fallen. We're in a warmhouse. Today it
feels like everything else is falling apart. But these are
(26:30):
the things I can focus on, and I know that
I have them, and that gives me joy. How you
look at it, where you put value, I think might
be one of the most important things you can do
for yourself. Yes, yes, everybody's watching, and by that I
mean your kids, your spouse, your partner, the people that
whose opinions you might want to put more value in
(26:52):
instead of the rest of the world and people on
the internet.
Speaker 2 (26:54):
What did doctors say, those who mine don't matter and
those who matter don't mind?
Speaker 1 (26:59):
Oh?
Speaker 4 (26:59):
Yes, right, thanks a good mantras. It really is.
Speaker 1 (27:02):
A good mantra. We go back to some of those
that are just like there was a reason why this
was so catchy. Doctor Cole Hayes, you have been outstanding.
Thank you for being such a great guest today. I've
really enjoyed this conversation and appreciate you so much. Thanks
for all that you're doing with your practice. Behavioral health
is Sentia Health. She's been there for the last four years.
(27:22):
And are you taking new patients?
Speaker 4 (27:25):
Yes? Absolutely, Okay.
Speaker 1 (27:27):
Essentia health dot Org can look up doctor Alexandra Colehes
or any of her other partners over in the behavioral
health department. Thank you so much for coming in.
Speaker 4 (27:36):
Thank you for having me Corey.
Speaker 1 (27:39):
Just having that conversation with doctor Cole Hayes lightened my
mental load. Something to be said about being able to
talk out whatever is going on inside your mind.
Speaker 4 (27:51):
That alone can help lighten the load a little bit.
Speaker 1 (27:53):
On the next Dare to Ask podcast, we go back
into the world of weight management. Think about how many
ways things like semiglue tithes have changed just over the
last year. If they're right for you, or maybe this
is exactly the thing that's going to be perfect for
you to reach your goals and get to a healthy weight.
That's upcoming on the next Dare to Ask podcast episode.
Speaker 3 (28:16):
The information contained in this podcast is not intended to
be a substitute for personalized professional medical advice, diagnosis, or treatment.
The information is general in nature. If you have questions
or concerns, please contact your provider.
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