A Conversation About Childhood Depression With Grace Lester, LMFT

Grace, will you tell me a little about your education and background?

I received a sociology degree from Hanover College and went on to earn my MSSW at the University of Louisville.  I am a Licensed Marriage and Family Therapist (LMFT ) and I have worked in the field of child and family therapy for 13 years.  Currently, I work as a supervisor and school-based clinician in a community mental health organization.

What do you think is most important for parents to understand about childhood/adolescent depression?

The word “depression” can be scary for parents so there is a tendency to avoid thinking about it – understandably – but parents should know that depression is very treatable.  Whether it is organic or situational in origin, it is treatable.  Depression can be a very natural reaction to trauma.

Can you tell me more about depression being a natural reaction.

Yes. A lot of times people equate depression with “brain chemistry” or a genetic predisposition but Depression can be a normal response to an abnormal situation such as abuse.  And, again, it is very treatable with the right interventions.  I really want to stress this point. There should be no stigma.

What are some differences in symptom presentation of depression in children and teens?

The biggest thing I ask parents to look for is a change in functioning. Has their child lost interest in activities they once loved?  Are they withdrawing or isolating? Is he or she having a change in mood patterns out of the norm? Are there changes in appetite or sleep (either too much or too little)? Depression doesn’t always look like the stereotypical picture of someone who is simply sad for an extended period of time.  They may have trouble focusing on the task at hand.  This is where parents or teachers sometimes make the mistake of thinking the problem is an ADHD issue when it is really a Depression or Anxiety issue. Think about it as an adult: If you are struggling with something it occupies your mind and you may have trouble focusing on what you need to be focusing on.

Some parents will say my child isn’t super sleepy or distracted or isolating themselves but then I will ask if their child has been more irritable than usual and they will say, “Yes! Absolutely. Every. single. day!” Parents don’t typically think of irritability as a sign but it can be the number one symptom in young people.  Feeling depressed and/or anxious is really irritating to experience.

Would there be one thing you see children struggling with the most in treatment?

What I see the most specifically in community mental health is the accumulation of stressors and the effects of poverty.  Now I am not saying being poor makes a child depressed but the multiple systemic stressors and crises that impact families and communities in poverty can lead to an emotional fatigue and difficulty dealing with everyday stressors.   We can’t forget too the impact of community violence.  Where I work children lose friends, family members and neighbors to gun violence on a regular basis.

Even if the family is healthy but they are surrounded by violence; the children are still experiencing trauma.  

A child may be just beginning to heal from the loss of a loved one and someone is killed again.  It rips everything open.  We can’t underestimate the impact of gun-related violence in the mental health outcomes of our children.

Do you see medicating a child as a treatment approach heavily utilized in your community?

I can only speak to my experiences in my community, where typically a pediatrician will give a child a referral for therapy before they prescribe medications.  It is more difficult for physicians  to prescribe ADHD meds in my state  now due to increased regulations.

Wow. That is a huge change from what I experienced in my work and in my community.  When I worked with children and teens in the school system in Indiana I saw doctors prescribing left and right.  Why do you think it is so different in Kentucky now?

There has been a big push to regulate. Very few of my clients are on medicine but that may also be because I am slow to refer for medicine.

Do you think that has anything to do with the opioid epidemic in your region?

Yes. I am sure.  However, even before the epidemic the culture in my office was to “go low and go slow.” Meaning we do not take the option of medication off the table but if it is used we will do the lowest dosage at the slowest rate.  We want to be able to take away the stigma for people who truly need medication.  Some children can’t go to school without using their medication for ADHD or anxiety.  They may be too distracted by their symptoms to learn in school and we fear they may be passed along without having their educational needs met.  I have had some children try to go off of their medication and it was difficult.  I think for some people who are so multi-stressed; medication is needed.  It is unrealistic to expect for all those other stressors to change so that a child can go without medication.

What do you think of the medicalization of mental health? Meaning there are a subset of parents going to primary care doctors for prescriptions with no desire to enter into therapy or adjust lifestyle choices first?

For parents who are considering medication without therapy I would have a few fundamental questions so I could understand their motivation: What are their beliefs about and experiences with therapy?  Do they believe it is a sign of weakness or reflects poorly on them as a parent? Or maybe they haven’t been to therapy and don’t know the value it can have to overall healing.

Any misunderstandings about therapy you would like to clear up for the general population?

Going to therapy does not mean you are weak.  In fact, it is quite the opposite.  There is strength in recognizing you need help and asking for it – incredible strength. We all could benefit from therapy.  Just like a car needs a tune up. Therapy can do wonders for self-care.

What changes would you like to see in the mental health community?

The changes I would like to see are actually occurring.  There is a trend toward home based and school based treatment which I fully support.  I think it’s important to have a systemic approach in therapy because humans are social beings.

Children don’t get hurt in isolation so they shouldn’t have to  heal in isolation.   

Not every client-clinician relationship is the best match.  I would like to see clients find the right fit if the therapeutic relationship is not working. If they can’t because of insurance or transportation barriers I want parents and teens to feel empowered to collaborate with the clinician. Please work through the issues with the therapist by telling him/her what would better help you.  I want clients to know they have the right to advocate for themselves.

The therapist isn’t the expert on you. You are on the expert on you. You get to have a say in your therapy.

So you want clients to feel empowered to play an active role in their treatment?

Yes!  Of course.  And if there are cultural differences or power differentials they (the therapists) need to acknowledge it and put it on the table.  Therapists may not know what it is like to be a minority or transgender but ideally they want to understand.  Clinicians are willing to collaborate and adjust their approach and understand again the therapist wants to learn about the spiritual, cultural or racial differences that may exist. They should not be barriers to treatment.  Bottom line, I want the client to feel empowered.  If this isn’t your experience with your therapist time to find a new one.

Biggest piece of advice for struggling parents?

Actually, this is part of my intake process: Where do parents get their support? Most say they don’t have time for it.  But think in terms of a flight attendant.  If you have flown before you know they tell you to put on your oxygen mask before you put on your child’s mask.  Because if you have nothing to give, you have nothing to give.  Therapy is not pampering. It is acknowledging you may need help and when we feel bad we have depleted resources to give to our children.  Parenting is all about giving.  If you’re hesitant about therapy, you may ask yourself:  What is the worst that can happen if I seek therapy or my child does? What’s the best thing that can happen?

Advice for teens out there who may be reading?

My advice for teens that may be reading is to get good help and not just from online sources.  While there are helpful resources online there is also information/advice on the internet that is not helpful or restorative. Straight up – it is hard to be a teen. What you are experiencing is valid. And you don’t have to struggle alone. Sometimes reaching out for help is the best thing. Let someone know. It can be a leader, coach, teacher or trusted adult.  With help it can get better. Don’t give up.  And you don’t have to talk about your feelings ad nauseam.  In fact, when you are depressed you are in your feelings too much.  There are actual ways you can reshape the way your brain is thinking and feeling.  Tools you can use. So ask for help and know it will get better!

5 Reasons Why It Is Easier To Feed Your Kids Real Food

We can make up all kinds of reasons as to why it is easier to feed our kids processed food.  But I am here to tell you we have been sold a bill of goods by real fine advertisers and the general population at large.  Please humor me for 3 minutes of your precious Friday and read further as to why I think they are just plain ole’ wrong.  When you buy real food from a farm and not a factory there is so much you don’t have to worry about.

You don’t have to read labels.  Yep, what I am offering here is rocket science, people.  Food from the Earth doesn’t generally sprout up with labels.  Now you may get stickers, which makes me 10 kinds of crazy but we can ignore those unless we are confused as to whether we are reaching for cilantro or parsley, in that case, stickers are necessary – very necessary. What I am so eloquently attempting to state is you don’t have to worry about ingredients because there should only be one, the actual food you are eating.  A grape is a grape.  Ahhh… the simplicity.

You don’t have to count calories.  When you eat real food you don’t have to be concerned about how many calories are residing in your broccoli or spinach because well it’s healthy and it just doesn’t matter.  Food becomes about taste and nutrition and not about whether or not you are meeting the numerical table of Weight Watchers.

You don’t have to count added sugars.  Who wants to do mental math all the way through the store?  Not this lady.  I try to limit the amount of times I have to add and then re-add math in my head.  It’s not fun. Sorry, Mrs. Lacy.  With fruit, I just load up and try not to go overboard for the day when serving it to my kids.  I don’t have to count one dang thing.  Just serve it and feel good.  And it feels so good to be so right.  Doesn’t it, mamas?

 

This is Mrs. Lacy. The math teacher. As you can see she is not pleased with my comments. Just ignore her and be happy like me you can reduce your counting at the store.

 

 

 

You don’t have to feel guilty.  I don’t know about you but I always feel a twinge of guilt when I give my kids something I know isn’t really too healthy.  Not that I should but I do and I think most mothers would agree.  We look for reasons to feel guilty sometimes.  Well… I write about mental health and nutrition and healthy lifestyles so this is my particular arena of guilt.  If I give my kids a bag of Annie’s cookies; I feel guilty.  If I give them a bag of strawberries; I don’t.  Honestly, none of us need the negative feelings so I will get straight to the point.  It makes me feel good as a parent when I feed my kid’s healthy food.  I actually derive joy from it and it builds my confidence knowing I am doing what is best.  Even if it means I am throwing in some carrots instead of a granola bar.  I will take what pleasure I can get.  Kapeesh?

You don’t have to spend a ton of money.  Real food is cheaper.  And there is no one on this planet that can tell me otherwise.  Okay maybe I would believe Oprah but no one else.  Ok?  No one.  Real food, pound for pound, is cheaper than processed food or fast food.  End of story.  Now this is where you may want to use Mrs. Lacy’s handy math skills.  Look at the cost for a pound of beans, peas, rice, corn or bananas and compare it to the processed version.  The rice cereal isn’t going to look so cheap anymore nor are the corn chips.  Sorry, Doritos! On a side note and I promise this is no lie.  Last week, a Doritos helicopter flew over my Wichita neighborhood and dropped individual bags of chips to the ground.  I swear to you.  And I stood there like an ice statue straight out of Frozen.  I could not believe my eyes.  What great heights (pun definitely intended) a company would go to get you to buy their product.  It’s not like this is Boston. They are hovering over Wichita, people.  Think of the power and influence they have over our lives.  These are the individuals who want us to believe that real food is expensive because then we wouldn’t buy their stuff.  And no, I didn’t take their chips.  Thought about it but that doesn’t really go with my whole eat real food theory.

Now I will leave you with my profound wisdom to enjoy your weekend!  Remember if you feed your kids real food you can get out of math and get out of guilt.  Win-win if you ask me! Little changes are all you need to get started.  So get to the store and grab your real food.  Just watch out for the hovering Doritos helicopters.  Seriously.

3 Reasons Living In Wichita Improves Your Child’s Mental Health

Looking for reasons to feel good about living in Wichita?  Well, stop right here.  Really, don’t move your mouse or swipe your finger.  If you are visiting this site and, in particular, my post then it’s safe to bet you have children.  And if you have children then you are well aware they have their own set of feelings, thoughts and behavior.  The delicate balance of these three little components makes up your child’s emotional well-being.  I am sure you keep up on the news, even a little…usually hiding in a closet on your smartphone or cuddled up in your pajamas in bed with one eye barely open, nonetheless, you are current.  So you don’t really need this child therapist to tell you our small people are reaching a pandemic level of illness.  Anxiety and depression have increased by 30% in American teens.  Suicide is now the second cause of death among adolescents aged 15-24 and that rate has doubled in the last 10 years.  I could continue but I will get to the positive side of my story because there is, in fact, a positive side.

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Tricks To Reduce Testing Anxiety For Students And Teachers

 
Testing anxiety is what the psychology world likes to call performance anxiety.  Similar to feelings of fear one may experience before heading out on stage, testing anxiety can leave the sufferer drenched in sweat, heart pounding with a thought of…”How the heck do I get out of this situation?”  The student or the teacher is equally susceptible to anxiety’s grip.  Lucky for all those white-knuckling it through exam time there are a few tricks up my therapy sleeve.  We really can save you from those pesky intrusive thoughts that keep you zeroed in on failure rather than success.  You ready?  Here we go.

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Why You Need To Get Your Kids Talking

 

Kids who live with depression, anxiety and/or OCD spend an extraordinary amount of time in their head. Ruminating over negative thoughts, worrying about past and future situations and focusing on scary and sad feelings leaves many children and teens zapped emotionally and physically.  They are too consumed by what is happening in their mind (real or not) to focus on what is occurring outside of themselves.
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Call Me Anything But A “Stay”-At-Home Mother

You can shout, “Hey You!”  Call me “Old girl.”  “Lady.”  “Middle-aged mother.” I would even answer to: “Hey woman with the stray black hair on her chin.”  Because the names would all be true.  Call me anything but a “stay”-at-home mother.  This name is more than a tad inaccurate and in a world of fake news accusations and lies passed as truths; I prefer to come as close to honesty as I possibly can.  Yes, I live in my home but I do a little more than just stay there.  Don’t you?

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Why I Refuse To Compete As A Parent

If parenting is judged on personal aesthetics, you know I am losing the battle.  You can tell by my outfit I am not competing.  If you look closer, you can tell by my behind I am completely out of the competition.  But it isn’t just about who looks the best in their mom jeans anymore.  “OMG Becky look at that…” Yeah, that’s right.  I just quoted Sir Mix-A-Lot.  And?

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Reduce Back To School Stress In 5 Simple Steps

Returning to school can be a trigger for many children, teens and even parents.  The flexibility of the summer gives way to the rigidity of the school year and with it comes an increase in anxiety, acute and chronic stress and depression.  Whether your child struggles with a clinical diagnosis or not does not take away from the impact the beginning of an academic year can have on a child’s thoughts, feelings and behavior.  Make sure your child gets off to a good start when the school bell rings.  Try out my ideas below:

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3 Ways To Treat OCD Without Medication

One of the most important steps in recovering from Obsessive Compulsive Disorder is understanding what it is you or your child may be up against.  Obsessive Compulsive Disorder (OCD) simply put is a form of anxiety that centers around obsessions and compulsions. While some new research points to an impulse control disorder as the heart of the illness; I find the largest aspect sufferers grapple with is the excruciating anxiety it imposes.  OCD looks a little like this:  A person has an intrusive thought.  This thought in turn creates a feeling of anxiety.  The person does not like the feeling of anxiety and, therefore, creates a compulsion to reduce the anxiety.  Hit replay.  Over and over and over.  Repetition of troubling thoughts/obsessions leads the sufferer to falsely believe there must be truth and meaning to the thought where no meaning truly exists.

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Nutritional Benefits Of The Watermelon

Nothing says summer like a nice, big slice of sweet watermelon.  Comprised of nearly 91% water, this delicious fruit helps detox the body by flushing the system of toxins and excess fluid.  Particularly love the juicy pieces of pink flesh?  Go ahead and swallow the seeds and rind too! All is edible with the rind containing more chlorophyll and citrulline than the core.  Dr. Mercola informs us that “citrulline is converted to arginine in your kidneys, and not only is this amino acid important for heart health and maintaining your immune system, but it has been researched to have potential therapeutic value in over 100 health conditions.”  No need to list 100 health conditions.  Just eat watermelon and know you pretty much have it all covered.

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