(bright music) - [Narrator] Major support for this program was provided by Nancy and Nyle Maxwell, Emerson, Kathy and Charlie Izard.

Additional support was provided by Amanda Jensen and Scott Bonneau, Amado DeHoyos, Georgetown Health Foundation, Kristen and John Nelson.

And by... (pleasant music) And also by... (pleasant music) - For more information and a full list of funders, please visit us at how are we today.com or aptonline.org.

(pleasant music) The information provided in this program is for general educational purposes only, and is not intended to constitute medical advice.

This is not a replacement for therapy and does not constitute therapeutic services or a therapeutic relationship.

For personalized medical guidance, or in the case of an emergency, please contact a healthcare provider.

(cheerful music) (cheerful music continues) (cheerful music fades) (dice clatters) - All right.

4, 5, 6 (groans) Oh no!

- You have landed on unexpected layoffs at Work.

Roll to see if you survived.

- Alright, let's see.

(slow cheerful music) Your position has been terminated immediately and your insurance coverage ends in a week.

Go back two spaces and go buy marketplace health insurance.

Gosh, I hate this game, you guys - What an unlucky roll of the dice Mariel.

- Well, Bella, that's just The Game Of Living, kid.

- I hope I don't land on that space.

Knock on wood.

- Uncle Tyler, it's your turn.

- Earth to Tyler.

- Uncle Tyler.

- Oh, sorry everyone.

How are we today?

I hope you're doing okay.

You caught me in a moment of doom scrolling, which I think all of us can admit is a bad habit we all participate in.

There's just so much going on in the world right now that it feels impossible to keep up with it all or not comment or try to fix it or not yell at somebody or get distracted.

Wait a second.

Which spot am I on again?

- You landed on the baby space remember?

You have a child now.

- Yeah.

- And you gotta take care of it, so please pay attention.

- Could you guys imagine having a child in this economy?

Like, do you guys even know how expensive diapers are?

I mean, think about health insurance.

There's this content creator that I follow that did an expose on this very issue.

The things they talk about, it makes your blood boil and just lemme show you what they highlight okay?

I'm gonna bring this up real quick.

Just one second.

- Uncle Tyler, can we please just play the game?

- You're gonna wanna see this.

All of you are.

- Hey dude, come on.

You need to take a breather.

You've been on your phone ever since we got here.

Oh, Dr.

Erin!

- Hey everyone.

- Dr.

Erin, I didn't know you was coming over.

- I was for board game night that I see you guys started without me.

- I think I forgot to tell you that we changed the time.

- You got distracted and forgot to update me, didn't you?

- Maybe.

- You were doing one of those online quizzes to figure out which Roman Emperor you'd be most like, weren't you?

- (groans) I just, I always hope I get Marcus Aurelius, but I always get Marcus Antonius.

- You're such a Marc Antony.

- Well, the father of Stoicism would probably say that you could use some help accepting the things you can't control and focusing on the things that you can control.

- But I feel like I'm in this vicious cycle, because I can't look away from the bad, right?

So I run to the good, which isn't even really that good.

It's just a form of dissociation, which is addictive.

And it takes my mind off the bad stuff for a second.

But eventually I'll peek back at the bad because like a car wreck, you can't look away.

And I don't know, I just, I feel like I'm not doing enough.

- Tyler, I think that's normal.

I mean, I think that's a normal feeling that we all have.

In fact, I think it's normal to feel a little lost with all the stuff we get flooded with all the time.

But just like we can't fix or save every person's problems, we also weren't meant to take in all the information of everything that's going on all the time.

- Tyler, you know with my ADHD, having control is a typical balancing act, especially when I get too focused on fixing or doing everything, just like trying to help everyone all the time, I can't focus on everything I need to do all at once.

And if I let the world's problems in too, I get myself stuck in a really bad log jam.

- It starts to feel like you're being bombarded and you have to care about every single person and every single issue.

And I just like, it gets to the point where I don't even know where to start.

- Yeah, I feel like I'm always being told how to feel and what to do.

And the worst is how to look.

I really like pizza and I need my phone to stop telling me I should take weight loss meds.

- Yeah, let's not do that.

I just, you know, I miss the internet when it was just silly memes and MySpace.

- Remember Tom from MySpace?

He was the best of us.

- We miss you, Tom.

- Most of us really miss Tom.

But it's important to remember that we can't totally submerge ourselves into the problems of others without checking in on ourselves from time to time.

That can actually just cause more harm than good.

It can lead us feeling frustrated, distracted, anxious, depressed, or apathetic or dissociated even.

So even if we have the best intentions for helping people, either online or in real life, we have to remember to focus on ourselves sometimes.

- You're right and I need to put this down right, and I should focus on what is right in front of me with the people that I care the most about.

Okay, so Mariel, pass me the dice.

- Let's be in the moment here, my guy.

- Let's be in the moment with each other and here we go.

(door clicks) - Mind if I come in?

- Yeah, sure Barb, but aren't you supposed to be on the night shift right now?

- No, I'm supposed to be, but I got sent home.

Is everything okay, Barb?

I mean, I guess I just, hospital sent me home early so... - Did something happen?

- I mean, kind of.

I don't think it was enough of a big deal to send me home, but whatever.

(gentle music) - Do you wanna tell us what happened?

- Yeah, sure, I was looking after this young patient, a teenager, and he had come in for a broken leg, and so I told him that he needed to stay in bed so that we could get him an x-ray.

But this kid was really impatient, so he kept trying to stand up and I told him he really needed to stay in bed so he didn't hurt himself.

Things were hectic like they always were.

So I was working on my charting and this kid kept trying to walk around.

He was complaining that no one had come to see him yet.

And I said the doctor would be with him when he could.

I mean, it's the emergency room.

Everyone needs help.

Like what do you expect from me kid?

Anyways, I was checking on my other patients and of course this kid gets up again and he knocks over this cart of all the supplies and it gets everywhere.

And I go in and I tell him he really needs to stay in bed and that he's being really disrespectful.

And I didn't notice that his mom had shown up.

And then she got really mad at me and told me that I was the one being disrespectful and that her son was just in pain and scared and whatever.

And she just kept going on and on and I just snapped.

I said something I probably shouldn't have.

So naturally, this is of course, when my boss happened to be walking by and she told me to apologize and then she took me outside and told me to go home so.

- Barb, you're like the most patient person I know, and I know we all get frustrated sometimes and you were probably doing the best you could, but that just doesn't really, - Doesn't really sound like you, Barb.

- I hate to ask Barb, but did you get fired?

- No, Bella.

Honestly, I think my boss was just more concerned than angry.

She told me that I've been seeming really kind of on edge lately and cold and I don't know, maybe she's right.

- Is that how you've been feeling?

- Yes.

I don't know.

I just feel like something's off.

I just haven't been sleeping much, so I'm exhausted all the time and I'm so busy that I like never have time to eat.

So I'm hungry all the time and oh my God, I'm so sorry.

I didn't even think to ask.

- Oh, it's okay.

That's what they're there for.

- I just, I'm so overwhelmed right now that I can't think straight, and I'm trying to keep everything together, but it feels like it's all, it feels like it's all falling apart and I just, I think something might be wrong with me guys.

- Barbara, it's okay.

- Yeah, Buddy, you know that you're safe here with us, right?

We're all here for you for whatever you need.

- You have a really difficult job Barbara.

Can I ask when was the last time you took a break?

- I honestly don't remember, but I'm used to working long shifts, so why is it all of a sudden so hard?

- Well, why don't we start there?

Why don't you tell us what a day typically looks and feels like for you?

- You know, some days it kind of feels like I'm working at a busy restaurant.

I know my job, it's a lot of work getting my hands dirty, but if I don't do my job, no one else could do theirs because it all starts with clean plates and utensils, right?

So I try to stay in my lane and focus on what I need to do, but without fail, I'm constantly getting dragged into someone else's dilemma.

(upbeat rock music) (phone rings) And honestly, it feels like I'm wearing multiple hats all the time.

I just know that I'm gonna have to jump in to do someone else's job.

(upbeat rock music) (upbeat rock music continues) (cooks faintly speaking) - Shut up!

(phone rings) (dramatic music) (spoon tinkles) It feels like my mind is just broken.

- Barb, your mind is not broken.

That's the first thing that I want you to know.

Okay.

Secondly, it's actually really common for people in the helping field to struggle with something called compassion fatigue.

As a psychologist, I've dealt with it myself.

- Compassion fatigue?

- Yeah, it's kind of like burnout, but it's really for specific situations where someone's expending a lot of energy, being compassionate for and helping others, especially when those others are struggling.

Even just watching the news and trying to keep track of everything going on in the world can lead to compassion fatigue.

Humans really weren't meant to take in all of the information that we get from social media.

Helping others is so meaningful and important, and you do that every day at work and with your loved ones.

But sometimes if you overextend yourself or spread yourself too thin, it can be impossible to take care of your own needs, let alone the needs of others.

- Right like how the airlines tell you to put on your own oxygen mask before helping others.

If you can't help yourself when you're struggling for air, you can't help other people right?

- Exactly.

- Well, if I could be honest, the other thing that's really hard to deal with lately has been you guys.

I don't say that to be mean or rude.

I mean, I love you guys, you're my best friends, but I don't have a mental illness, so sometimes it is really tough for me to know what to say or what to do or how to be there for you.

All of you work so hard on your symptoms and it's just, sometimes I just, I don't know how to handle it.

Whether it's going through a hypomanic moment or having to talk someone through anxiety and cognitive distortions.

(slow dramatic music) Or helping someone with their ADHD and managing their symptoms.

(slow dramatic music) It is just, I want to, and I will be there for you.

(slow dramatic music) But sometimes it can be really hard to minimize my feelings and my emotions and my problems.

If I'm upset or if I'm going through something, it could be really hard to ask for help because I don't want ask for help when you guys are going through so much, and you're dealing with your own mental health issues.

And often I feel like my emotions come in second place and sometimes I just wanna be a priority, and I just dunno how to approach that and ask that.

And oh my God, you guys probably hate me right now.

- Barbara, we don't hate you.

- Just because you don't have the same symptoms or diagnoses as us doesn't mean that what you're feeling isn't valid and makes it less important.

- It's okay to not be okay, right?

And that's what my therapist always tells me.

- Exactly, Bella.

Everyone's mental health is important no matter what state it's in.

- That's right.

No matter who you are, whether you're young or old or rich or poor, wealthy, I mean... - A beaver.

- A beaver, we're all guilty of this from time to time.

But you gotta remember, you can't compare trauma, Barb.

Pain is pain.

- Exactly.

That was really brave of you to say and you should be really proud.

I know all of us are really proud of you for saying that and being honest.

And to add to what Tyler said, comparative suffering and compassion fatigue often go hand in hand.

Your job is a really good example of that.

Whether someone comes in with a broken leg or a tummy ache, they both need help.

- Okay.

But I guess what do I do with all this?

Like, what do I do when I'm feeling compassion fatigue or burnt out or neglected?

I mean, what do I do when I'm feeling so frustrated that I can't help or know how to help?

- I think sometimes the best place to start with this is with some boundaries.

Why don't we get cozy and get some snacks and we can talk about it and I have a little game we could play.

(pleasant music) Okay so remember when we used to play that game with the three categories where you would separate three people into those three categories.

It was like Mary- - Dr.

Erin, you can't say the name of that game in front of Bella.

- I'm in high school, Barry.

I know what the game is and I've heard worse.

- And it's not actually the same game, it's just the same idea of thinking of something quickly and sorting it into categories.

This game is actually called Brake, Boost, Balance.

- Hmm.

- Here's the idea, when we start to feel compassion fatigue, we really need to take immediate action to reset.

Now the goal is to do more of those reset things all the time so that we really set ourselves up for success.

But when you're feeling overwhelmed in the moment, this is a good game to play to pause and do something right now.

The first part is brake.

We wanna hit the brakes on something.

- Okay, so you mean like creating a boundary?

- Sort of.

It's similar to that.

What's something that I can hit the brakes or pause right now?

- Hmm like having Tyler hit the brakes on trying to solve every issue he sees online.

- Okay, okay, okay.

You got me.

- That's exactly correct.

For me, sometimes it means things like tasks at home or a work job.

Maybe if there's too many things, I'll put the brakes and not take that new patient on right now, because my plate is too full.

- So I can hit pause on my chores until next month.

- I don't know if your mom's gonna go for that one.

- Yes and no, Bella, the idea is to pick something that you can feasibly table until later, like next week or maybe next month.

- Speaking of chores, you guys know with my ADHD sometimes all I focus on is chores, but maybe I hit the brakes and just do one chore.

- Okay, so if I'm playing, maybe I could put a brake on trying to solve everyone's problems and maybe just focus on one.

- Exactly and then with the little bit of extra room we get from putting the brakes on something, we can do something for ourselves next.

- And give ourselves a boost.

- Barry, that's spot on.

Boost is all about focusing on building up those values based activities, the non-negotiables or the things that make you feel really good.

We can give that part a try now.

We can think of something fun and positive that we could add in.

- Having an extra pizza night with my uncle.

- That's fine by me kiddo.

- I think I wanna do an all dayer on the couch, lay down, get real comfy, play some video games with my fuzzy slippers and sweatpants.

- You've got the idea.

Yep.

We're giving ourselves protected time to really give us that boost.

- I haven't had a proper dinner in ages.

I think I'm gonna book a date night for myself at that steakhouse on third street.

(group groaning) - [Group] The steakhouse the house on third street.

- Hey, I have one Dr.

Erin.

I'd like Tyler to roll the dice because we've been here for like 30 minutes and it's still his turn and I wanna finish the game.

- I promise I will roll the dice once we're done.

I think we have one more, right Doc?

- Yes.

Balance.

The most important thing with preventing and treating compassion fatigue is building up a sustainable balance in life.

This step is actually the simplest.

We're just gonna pick a skill, a mindfulness skill, a breathing skill, grounding exercise.

- Like Sticky Thoughts?

- Or Ice Face.

- What about Find 10?

- Yes, all of these are great.

Any of those grounding or regulation or mindfulness skills that we've learned together.

So to recap, brake, hit the brakes on something; boost, add in more of those meaningful activities; balance, pick a regulation skill.

- Dr.

Erin, this is honestly exactly what I needed.

In fact, I think I'm going to start right now.

I am gonna make that reservation at that steakhouse.

- All right.

- I love you guys.

I really can't thank you enough.

But Tyler, you never mentioned what your brake, balance, and boost would be.

- Well, I think we all know what my brake needs to be, but my boost and balance are actually the same thing.

If the good doc allows for it.

- The great thing about all of these skills is that they can be whatever you need them to be.

- And that right there is what this is all about.

This conversation and everything we do on this show circles back to one thing, finding what works for you, period.

The conversation taking place right now in the mental health world is loud and messy, filled with people telling you what you must do, what you need to do, what you're doing wrong.

Even diagnosing you when they have no medical expertise telling you that if you don't fit into this box, you'll fail to get better.

I'm no mental health expert.

I'm very much still trying to navigate and figure out my own mental health issues.

But there is one thing that I know that is 1000% unequivocally take it to the bank true and it is this.

How you decide to deal with your mental health is not a one size fits all.

How you manage your mental health is unique because you are unique.

Everything about you, your personality, your life experiences, your genetic makeup, everything that makes you you, dictates how you get to deal with your mental health.

And maybe some of the things we've done on the show, some of the lessons maybe they don't work for you.

It's totally fine.

Maybe you're not ready.

That's also okay.

We just want you to know that we'd love for you to stick around and hang out with us, and learn about this crazy thing we call mental health.

Because so many of us are dealing with this unrelenting pressure every day to be perfect, to be right, to be saying the right thing.

And all of it is being asked of us to do it and accomplish it right now, which is impossible.

Rome wasn't built in a day, but the saying change can't happen overnight.

I don't know if I believe in that one 'cause yeah, you can't change your life overnight and you can't flip your mental health situation on a dime.

But you do have the ability to start that change right now.

Think about it, if you woke up this morning and you decided to finally book that therapist, that's change.

If you reached out to a family member or a friend to ask for help, that's change.

If you woke up this morning and you didn't use and you didn't drink, that's change.

If you got on that medication that you've been meaning to and you finally did it, guys, that's change.

Oh, look at me crying again.

But you know, like my niece Bella said, it's okay to not be okay, which is a true saying.

It's one we all know and one we love.

But maybe we could add a second sentence.

It's okay to not be okay, but it's not okay to stay that way.

Everybody in your world, whether you know it or not, us included, we want you to get better.

Give yourself permission to start yeah, because we're gonna be right here.

I'm just gonna be hanging out, learning and growing and crying and laughing and doing all that goofy stuff we do on this show.

So until next time, take heart, take care, and take your time.

It's gonna be just fine.

(gentle music) - [Narrator] Major support for this program was provided by Nancy and Nyle Maxwell.

(pleasant music) Emerson.

Kathy and Charlie Izard.

Additional support was provided by Amanda Jensen and Scott Bonneau, Amado DeHoyos.

Georgetown Health Foundation, Kristen and John Nelson.

(pleasant music) And by... (pleasant music) And also by... (pleasant music) For more information and a full list of funders, please visit us at howarewetoday.com or aptonline.org.

(pleasant music) (dramatic outro music) (cheerful music) (upbeat music)