Q&A with a Mental Health Professional: Vicki Harrison, MSW
Vicki Harrison, MSW
We asked teens from around the United States to anonymously send us questions that they would like to be answered by a mental health professional. Below, Vicki Harrison, MSW, Program Director for Stanford Psychiatry’s Center for Youth Mental Health & Wellbeing, thoughtfully answers some of these questions.
1. How do you approach someone you think needs help?
Start by listening. Reach out with simple phrases like “I’m worried about you. Is there anything I can do to help?” or “I’m here for you if you ever want to talk.” This can start over text or chat if that feels easier. If they open up, be an active listener, really letting them share and not jumping in right away with suggestions and solutions.
2. What is the best advice to give to our friends who might be experiencing depression other than telling them to go see the psychiatrist?
Start with offering validation and empathy before giving advice. Let them know you believe their feelings are real and that they deserve to feel better. Offering to connect them with a trusted teacher, a counselor or with an anonymous peer support line like Teenline could help. If you have been through something similar, sharing your experience and what helped you or didn’t help you can be a support to someone who is struggling.
3. How do I know if I need help?
If you are unsure whether you could benefit from outside help, don’t hesitate to ask. Some young people tell us they don’t feel like their problems are “serious enough” to be worthy of professional help, thinking it is reserved for others. Everyone deserves the opportunity to express their feelings, seek help and to feel supported, no matter how large or small the challenge. There is no magic threshold of symptoms that you first need to cross. In fact, addressing problems early is precisely how you prevent them from getting worse and will give you better chances for improving more quickly. Sometimes simply having one or two conversations with a trusted adult, peer or a mental health professional can be all you need to work through difficult feelings.
4. How do I tell my parents if I feel like I have depression or a mental health disorder?
Asking for help can be incredibly scary. There is still a lot of stigma around mental health and this can lead us to feel ashamed to speak up or somehow like asking for help is a sign of weakness or failure. The stigma comes from misguided messages from our cultures and histories that we’ve internalized and thus impose upon ourselves and our families. The truth is, asking for help is incredibly brave. And although it’s scary, telling someone what you are feeling can feel like a weight off of your shoulders. Saying the words out loud helps to externalize the feelings, getting them out in the open where you can more easily work through them with the support of someone who cares about you. If you don’t feel like you are getting the support you want from your parents, try talking to a trusted teacher or counselor at school or someone in your faith community who you think might be willing to listen without judgment.
5. How can you explain the true effects of mental illness to someone who doesn't experience it themselves?
It can be hard to explain this and for others to truly relate. Mental health professionals can help explain symptoms and impacts to family members because they have a lot of experience doing so. Trusted resources like NAMI offer a lot of resources including videos and written descriptions of mental health symptoms. Another option is to point to articles or online communities where people with lived experience of mental illness have written about their stories in beautiful and descriptive ways. Examples of these include The Mighty and TeenzTalk.
6. How can I feel like I’m doing something important?
This is such a great question for all of us to ask ourselves. Finding meaning and purpose in your life goes hand in hand with mental wellness. And research shows that giving to others through self-less acts boosts both mental and physical health. More and more, the prevailing cultural narrative seems to reinforce a very narrow view of what happiness and fulfillment look like. Yet what we feel connected to and driven by is unique to each and every one of us and those who simply seek out status, power or wealth often end up feeling unfulfilled. So don’t be afraid to try out new things, especially those that serve others. Grounding yourself in a higher purpose and/or finding and pursuing what motivates you can serve as an anchor and motivating force, especially during periods of struggle.
Vicki Harrison, MSW has over twenty years of experience working within the public health, education and mental health sectors developing innovative, community-based programs at the local, state and national levels. As Program Director for Stanford Psychiatry’s Center for Youth Mental Health & Wellbeing, she implements a broad portfolio of community-based projects promoting wellbeing, early intervention and increased access to mental health services for young people ages 12-25. This includes allcove - a first of its kind integrated youth mental health model in the U.S. and a national Media and Mental Health Initiative, partnering with the media, mental health and technology sectors to enhance the positive impact of media on youth mental health and wellbeing. She also serves as a founding member of the TikTok Content Advisory Council.
Q&A with a Mental Health Professional: Maryam Kia-Keating, Ph.D.
Maryam Kia-Keating, Ph.D.
We asked teens from around the United States to anonymously send us questions that they would like to be answered by a mental health professional. Below, Maryam Kia-Keating, Ph.D., a Professor of Clinical Psychology at the University of California, Santa Barbara (UCSB), thoughtfully answers many of these questions.
1. What’s the best path to take to help mental health?
If you suddenly had to run in a race, you would be so relieved, and have an easier time, if you had been exercising and training all along, up to that minute. In fact, instead of worrying, or being overwhelmed, you might think to yourself, “I’m ready for this!” Stressful events in life are like that sudden race: they aren’t predictable in terms of timing, but they are predictably going to happen, in that all of us have to be ready to face significantly stressful life events. The more prepared you are ahead of time for the bumps in the road, the better. And the more you “stay in shape” with your mental health, the easier it is to get through the parts of life that sometimes feel more like an endless and exhausting uphill climb, than a bump. The best path to take to help mental health is by having your mental health toolkit ready. Here are five key tips:
Find and nurture your relationships and support systems.
Make it a priority to find and then regularly participate in activities that bring you joy and meaning.
When possible, minimize your exposure to extreme stress, such as monitoring how much you watch media content that includes violence or other upsetting news items.
Practice mindfulness.
Take care of your physical health by eating healthy, getting regular exercise, and avoiding harmful substances.
2. How do you get diagnosed with a mental health disorder? What does the process look like?
If you are concerned about your mental health, want to get a mental health check-up, or just want some support, you might seek out a formal appointment with a counselor/therapist, psychologist, or psychiatrist. These licensed professionals can diagnose you with a mental health disorder once they have completed an in-depth evaluation of your symptoms. In the U.S., mental health professionals use a manual known as the DSM-5 which provides the standard classification system to diagnose a mental health disorder. Just like anytime you see the doctor, they will do their best to gather information about what you are experiencing, and how it is impacting your life, as well as what other factors may be at play. Usually, that means asking you a lot of questions, and sometimes it also means having you fill out some questionnaires.
3. How do you know if it’s just a phase or if you actually have a mental health disorder?
A licensed mental health professional is the best person to help you sort out whether something is just a ‘phase’ and/or if you have a mental health disorder. But remember, just because you get diagnosed with something doesn’t mean you will have it forever – it could technically be ‘just a phase’ too. Just like any illness, you are capable of healing! In order to figure out what’s going on for you, you might be inclined to start with a Google search BUT it’s important to not just rely on what you read on the internet for several reasons. First of all, you can run into inaccurate information there. Second of all, once you start reading, it’s common for people to feel like they might have every condition they read about even when they don’t (commonly known as “medical student syndrome”). Third of all, seeking out proper support early can only be helpful in preventing a mental health disorder. So there’s really a lot of reasons to get a professional evaluation, and assistance to help you through a difficult “phase,” no matter how short or long it lasts.
4. How do I know if I have depression?
Typically, you’ll notice that your mood is low for most of the day, nearly every day. You’ll also experience some related symptoms such as a change in your appetite, energy, thought process, ability to concentrate or make decisions, and/or ability to experience pleasure in things you used to enjoy. Sadness is a normal part of life, and in many cultures, it’s encouraged to be embraced as a tool that can help you reflect and bring you guidance. However, if these symptoms are getting in the way of your functioning, lasting for longer than two weeks, or are accompanied by thoughts about hurting yourself, you should immediately tell someone supportive in your life, and seek treatment from a licensed mental health professional and/or a medical provider.
5. How do I deal with nighttime anxiety?
It’s always helpful to get support from loved ones. Licensed mental health professionals can guide you in coping with nighttime anxiety. Some methods that tend to be useful in addressing anxiety include 1) creating a calming nighttime ritual (also making sure to “unplug” from devices early), 2) having a daily meditation or mindfulness practice that helps keep you grounded and provides you with some breathing techniques, 3) exercising consistently which has benefits for your body from the inside out, and 4) avoiding substances that can increase your anxiety, including caffeine, and sugar.
6. How can you prevent anxiety from taking over your daily life? How do you contact a therapist for anxiety issues?
The best trick is to just keep living, and give yourself that extra push to get through activities that your anxiety tries to get you to stop. The more you avoid activities, people, or places that make you anxious, the more the anxiety stays rather than dissipates. So, instead, commit to yourself that you will continue to embrace and seek life’s adventures whether or not your anxiety is coming with you on that journey. Accept that it might be there sometimes but know that it is most likely to go down over time, especially with anything you practice and have repeated exposure to. Seek help from a mental health professional for guidance and support in dealing with your anxiety – therapy can be incredibly useful for people who experience anxiety and know that the work you do for a short amount of time in therapy can last a lifetime. You can get a referral from your primary care provider, or look over a list of providers and directly contact one of the mental health professionals to schedule an appointment via phone or email, depending on what contact information they offer. Typically, providers will list their areas of expertise, so look for someone who lists anxiety as one of the issues they treat.
7. How do I know if I have gender dysphoria?
According to the DSM-5, gender dysphoria is defined as clinically significant distress or impairment related to a marked incongruence between your expressed gender (i.e., how you experience your gender) and your assigned gender (i.e., what your gender assignment was at birth) for at least 6 months. You also have to experience several other criteria, including a strong desire to be of another gender, which might include the strong desire to change primary and/or secondary sex characteristics, to officially receive the diagnosis of gender dysphoria. It can be helpful to seek support from an affirmative, licensed mental health professional for support, especially if you are experiencing significant distress or impairment (such as in relationships, school, or work) in your functioning.
8. How can I stop doing self-harm?
It’s important to recognize that self-harm is never going to provide you with a lasting solution, and it could ultimately cause you some serious consequences, so it’s great that you are motivated to stop. Seeking help and getting appropriate treatment from a licensed mental health professional can help you learn some healthy ways to cope, emotion regulation strategies, how to tolerate distress, how to improve your relationships, and mindfulness skills. These kinds of strategies can help support you to stop self-harm, and to prioritize self-care and self-compassion.
9. What are some distinct differences between ADHD and Autism?
There’s a lot of overlap and researchers are still trying to better understand the relationship between ADHD and Autism. It’s notable that approximately 30-80% of children with Autism also meet criteria for ADHD, and 20-50% of children with ADHD also meet criteria for Autism, so you can see that the two issues can go hand-in-hand. Social skills, language delays, and attention problems can impact people with either diagnosis. That said, someone with ADHD might be more likely to have difficulties with sustained attention, difficulties with organizing tasks or activities, high activity level, impulse regulation, or forgetfulness. Someone with Autism, on the other hand, may be more likely to experience difficulties in social interactions and communication, difficulties maintaining relationships, repetitive behaviors, and restricted interests.
10. How do I know the difference between having ADHD and just being lazy?
Most of us feel lazy at one time or another. Some of that feeling might relate to exhaustion, boredom, lack of motivation, or not enough reward to outweigh the draw of doing nothing. The main difference is that someone with ADHD (which only has a prevalence rate of 7-12%), has impaired executive functioning, and, at a neurobiological level, is experiencing difficulties with planning, organizing, and managing their impulses. Either way, if you are struggling with some of these tasks, it’s always a good step to get professional support in order to not only sort out the causes, but also find some solutions together.
11. How do I know if I have an eating disorder?
There are a number of different ways in which eating disorders will manifest themselves—including restricting food intake, excessive exercise, binging, purging, preoccupation with food, and feelings of loss of control about eating. The bottom line is that it relates to an unhealthy relationship with food and your body, and can include unhealthy behavior patterns, low self-esteem and self-worth, and difficulties in relationships. Engaging in disordered eating patterns can have long-term, severe negative health consequences. Thus, it is especially important to check with both a medical and licensed mental health professional to assess and get treatment for your health and mental health related to eating, nutrition, and learning healthy patterns.
12. Does Bipolar Disorder affect everyone the same way, with the same extent of highs and lows?
Symptoms and severity of Bipolar Disorder can vary quite a bit. Some people have years without symptoms. Some people can experience rapid shifts between highs and lows. Although genetics play a part, studies of identical twins demonstrate that genetics don’t fully determining the outcomes – one identical twin might have Bipolar Disorder while the other does not. If left untreated, Bipolar Disorder can get worse. It’s best to seek help from a licensed psychologist or psychiatrist who can provide treatment and guidance towards creating a long-lasting, consistent healthy lifestyle.
Maryam Kia-Keating, Ph.D. is a Professor of Clinical Psychology at the University of California, Santa Barbara (UCSB), where she oversees the Trauma & Adversity, Resilience & Prevention (TARP) research lab. She is a Licensed Clinical Psychologist and a key collaborator with the Center for Scholars & Storytellers. Her education and training were completed at Dartmouth College, Yale University, Harvard University, Boston University, and the University of California, San Diego. Her interviews on ways to protect mental health and promote resilience have been included in outlets with high volume readerships, including the Washington Post, ABC news, CNN, and Self Magazine. Her website is www.kiakeating.com and she is on Twitter @drkiakeating.