This episode is led by Ken Duckworth, M.D., chief medical officer, National Alliance on Mental Illness (NAMI). He leads a deep and personal discussion with individuals who have years of lived experience with serious mental illness (SMI). They offer valuable perspective that is useful for clinicians, individuals who receive care, and family members alike. Topics include cultural influences, the impact of diagnoses, the role and impact of peer support, therapeutic alliance, engagement in care, recovery supports, family involvement, and much more.

Transcript of Audio

Dr. Ken Duckworth (00:05): Welcome to the Medical Mind. Hello, I'm

Dr. Ken Duckworth. I'm a psychiatrist and the Chief Medical Officer of the National Alliance on Mental Illness or NAMI. The Medical Mind is a podcast about mental health, mental health treatments, and the people who benefit from those treatments and who experience mental health conditions. You'll be meeting three people today that I interviewed for NAMI's First book, You Are Not Alone. I interviewed over a hundred people for that book who use their name and share what their experience has been like, including what has helped them. This episode is co-presented by SMI Advisor, a clinical support system for serious mental illness and by NAMI, the National Alliance on Mental Illness. SMI Advisor is funded by the Substance Abuse and Mental Health Services Administration, SAMHSA, and administered by the American Psychiatric Association or APA.

(01:01): These podcasts include the real life experiences of people with mental health conditions and family members. Some of the content includes discussions of hospitalizations, topics such as suicide, that some people might find upsetting. If you're concerned about your safety or of someone you love, please consider calling 988, which is the National Suicide and Crisis Prevention Lifeline here in the United States. That is available 24/7. If you're looking for communication with someone, you can call the NAMI Helpline at +1 800-950-6264. This is staffed by 150 well-trained volunteers and is available from 10:00 a.m. to 10:00 p.m. Eastern Time, Monday through Friday. Drea Landry joins us from California. Drea has a master's degree in psychology as a certified peer specialist. She's an advanced wellness recovery action plan trainer. Drea, thank you for being here.

Drea Landry (01:57): Thank you for having me.

Dr. Ken Duckworth (01:59): Tell me a little bit about your mental health journey.

Drea Landry (02:03): I'm child number three of four and have always been the star of the family, and I say that sarcastically because anything unusual, outrageous, that could be done, I did it and I did it to the nth level and we all thought that was normal. I didn't realize that things were abnormal until my children decided to grow up and leave home because Lord knows I didn't give them permission to do that. I had never been alone before. I had always had somebody to take care of or somebody to take care of me, and they had the audacity to leave me alone for the first time in my whole life and I lost it.

Drea Landry (02:48): I lost it so bad that I became catatonic in my bedroom. I was literally laying on the floor looking at the ceiling, not eating, not bathing, not doing anything for dates, and my mom had keys to my apartment and discovered me on the floor and dumped a bucket of cold water on me and told me to get up that there was life without children and took me to the psychiatrist. And when I got to the psychiatrist, he asked me one question that has changed my life forever, and that was what was the longest you've ever stayed awake? And I told him seven days straight and he looked at me and said, "You have bipolar disorder. Take this pill. Don't get fat. See you next time." And it threw me for a complete loop because there was no explanation of where it came from, how I got it, how I could get rid of it. What do we do now? There was nothing. I became angry, extremely angry.

Dr. Ken Duckworth (03:51): So do I understand it correctly that this psychiatrist made a brilliant diagnosis in asking you about the number of days you hadn't slept yet, didn't really provide you more information about the possibility that you had bipolar disorder or how best to cope with it and manage it. Is that an accurate statement?

Drea Landry (04:10): That is an accurate statement, yes, absolutely.

Dr. Ken Duckworth (04:13): So brilliant on part A, but you had to figure out part B for yourself.

Drea Landry (04:18): Yes. I had my own personal stigma that I was battling, which was basically the only time I had ever really heard about mental illness as far as it being detrimental was in the movie One Flew Over the Cuckoo's Nest. I thought Nurse Ratchet was coming to get me, put me in the hug me jacket, and I was going to live in somebody's hospital forever in a day. I mean, and my home mental illness was, or mental health challenges I should say, was always upfront and personal because my mom used to talk about how depressed she was all the time, but it was done in a way where it was joking, oh, I don't feel well today or I'm really down today, but I don't have time for this, so let's go to the park or we're going to cook dinner or do this, that, and the third. So it was never considered something to take seriously to really dive into. It was just present but not really present. It was part of our norm for whatever life is.

Dr. Ken Duckworth (05:22): How would you think your culture influenced that set of beliefs?

Drea Landry (05:29): As a woman of color? I would say that we are always taught that we have what I like to call the Uncle Pete syndrome, and I stole that from Gertie Wilson with NAMI, so thank you, Gertie. So basically Uncle Pete is a character from the movie Soul Food and what he is, he was always stuck in his room and everybody in the family knew not to bother Uncle Pete. Everybody knew Uncle Pete was erratic. He yelled at you, he didn't talk to you, he was standoffish. You just left Uncle Pete alone and in the movie you would see them setting his food outside his door and you would see the door open him, shove the food in, and then when he was done, he would throw the dishes out and slam the door shut. And excuse me, the African-American families, we are taught that there's always somebody, there's that always that one person that you know is a little out there, they're a little strange, they're a little different and you just ignore 'em.

Dr. Ken Duckworth (06:36): They're a little bit like Uncle Pete.

Drea Landry (06:38): Yes, yes. A little bit like Uncle Pete. You just kind of ignore 'em. You accept 'em for the way they are. You don't feed into their excessiveness since I can't seem to say the other word. You don't feed into their excessiveness, you don't give them the power or the extra attention that they seem to be wanting to have, and you just leave life as if it's normal.

Dr. Ken Duckworth (07:06): Has that culture improved through your journey as a woman of color? Are you watching it improve? No,

Drea Landry (07:13): No. It has not improved. One thing that has gotten better is the fact that Barack Obama as president and his wife Michelle and Jill Biden, who is now the first lady formed a coalition for families who were part of the military that brought understanding about PTSD and about mental health challenges. And because Michelle Obama being a woman of color, brought a few more things to light for families of color to express themselves more and the mental health challenges that they have as opposed to hiding it away. It's still in some of the other deeper families who don't really pay attention to some of that stuff to where if you pray enough, then you'll be all right. If you do what I tell you to do, then you won't have to worry about that problem. If you don't stop that, I'm going to whoop your butt because you need to do what I say and not as I do. There are minuscule changes here and there, but it's not on a wide scale to where people can understand that mental health is part of their overall health and that it's not necessarily negative some of the things that you're going through, but there are ways to help manage it.

Dr. Ken Duckworth (08:40): Yeah. Were you ever told to pray it away?

Drea Landry (08:43): My mom's an odd duck. She was with me when I was diagnosed and she took it more personal than anything else because it made her face the fact that she had never been diagnosed as having depression. So no, she never told me to pray it away. Actually, she told me to go investigate. She said, it doesn't matter what he said, you go look it up, see what it means and get yourself together because you're going to make a difference. The only time I was ever told to pray it away was right before I got married. The third time. We had marriage counseling and I was talking to the minister about my challenges and the mental health issues that I was dealing with, and he said, Jesus can heal that.

(09:35): It took me for a loop. And I was like, okay. He said, no, no, no. If you believe enough, Jesus can heal that and you'll be fine. I said, well, I'm fine now. I said, I'm a whole lot better than I was. And walking my road of faith, especially in being married to a man who was deeply into what the Bible says. I had to learn a lot of scripture that helped me walk that fine line, and one of the scriptures that I read in Jeremiah said, I knew who you were when I formed you, and that helped me get through. So pray it away. No, the way I see it now is God allowed this to happen so that I can reach out to other people to let them know that they're not alone, that they're not broken, broken.

Dr. Ken Duckworth (10:23): You can make meaning of what you've been through to help others. Let's talk a little bit about that. How has your experience shaped your journey to help other people as a peer specialist, as a wellness recovery action plan facilitator? How did that come to pass?

Drea Landry (10:40): It has forced me to open my mind to different forms of treatment, learning different coping skills, learning more about myself and what it is I actually like and what it is I can do to help me manage. And in listening to other people and how they go through and giving them different insights, I learn from them just as much as they learn from me. And it has been awesome. It's been amazing.

Dr. Ken Duckworth (11:10): Any mental health providers provide helpful perspectives. Now, the first one made a diagnosis, which turned out to be accurate. It sounds like other mental health providers been helpful, things they've approached, how they've treated you, how they've worked with you.

Drea Landry (11:28): I had one young lady who was shortly after the first guy who, a poor lady. She had just come to her wits' end because medication proved not to work for me at all. And she said, Drea, I seriously don't know what to do with you. And I said, well, why don't we work together and figure out how to help me? I said, because where is it written in somebody's book that I have this diagnosis and I have to take that pill to feel better? She said, you know what? You're right. Let's do this. And so we work together to develop a plan for me to help me. And I think she's just the most amazing provider.

Dr. Ken Duckworth (12:07): The providers call that the therapeutic alliance, that you face the challenges together, you work together. And it sounds like she was a master at that.

Drea Landry (12:18): Yes, she was. She was awesome.

Dr. Ken Duckworth (12:22): And acknowledging that she didn't have the answers, sounds like that was key to your experience, that you could work them together.

Drea Landry (12:29): Yes. Acknowledging the fact that I wanted to do something for myself and helping me discover new ways to do it because all the traditional methods didn't work for me, really improved my outlook on my outlook on life and my recovery.

Dr. Ken Duckworth (12:47): Beautiful. What does living well in recovery mean to you?

Drea Landry (12:53): It means I can hold my head up high and accept myself as a human being as opposed to living through the lens of what a diagnosis has given me. I know I have my good days and my bad days, but I keep on trucking like they have to in the old commercials with the big shoes you keep on trucking, you move forward and it makes me feel stronger as a person.

Dr. Ken Duckworth (13:21): What do you wish mental health providers knew based on what you've learned? What do you have a message for them?

Drea Landry (13:30): Listen. We understand you have book knowledge. We understand you have practiced in school and have seen some of the things in the field when you are doing your internships or whatever, but honestly, listen to the person that you are serving. You may know the physiology of a body, but you don't necessarily know the physiology of my body. And I'm telling you, I'm sensitive. I'm telling you I'm going through these things. Pay attention to what I'm telling you and fixated that on what your knowledge is and let's blend it together and do that with those that you serve. Because a banana over here may work for this person, but an orange over here may work for me. So, listen.

Dr. Ken Duckworth (14:27): I love that. How has your diagnosis shaped the life that you've built?

Drea Landry (14:35): It's made me a better comedian.

Dr. Ken Duckworth (14:38): How so? Let's go.

Drea Landry (14:41): Well, I remember when I was first diagnosed, I was so scared and I hid away for so long and I just identified myself as my diagnosis and just didn't want to be bothered. Now I utilize it as a way to show people that we're not the monsters under the bed. It's like I'll be talking to folks and they'll go, yeah, those crazy people over there, they be doing this, this, this and this. And I said, really? And what do those crazy people over there look like? And they'll describe somebody with their hair standing up on there looking like Charles Manson or whatever else. And I said, okay, can I tell you a secret? And I'll go, what? I said "I'm one of them crazy people." "Drea, stop playin'." No, really. And it changes their perspective. They stop thinking in those ways of all people with mental health challenges want to do is hurt somebody or shoot up a school or do something silly. No, we live healthy lives. We raise families, we take care of ourselves. We work, we have businesses of our own. We're just like you. We are one.

Dr. Ken Duckworth (15:52): You're still overcoming all those negative stereotypes that you described, so you get a diagnosis in your first thought is One Flew Over the Cuckoo's Nest, Nurse Ratchet, and it's so much different than that.

Drea Landry (16:04): Yes, it is.

Dr. Ken Duckworth (16:06): Elisa Norman is here with us from Atlanta, Georgia. She's active in NAMI as a presenter with NAMI's In Our Own Voice program and our Peer Connections program. Hello, Elisa.

Elisa Norman (16:18): Hi.

Dr. Ken Duckworth (16:19): How are you doing today?

Elisa Norman (16:21): I'm doing just fine.

Dr. Ken Duckworth (16:23): Thank you for being part of this. We're really interested in how people's mental health journeys have gone. Can you tell me a little bit about your mental health journey?

Elisa Norman (16:34): I sure can. My mental health journey started when I was 25 years old. I was newly married and just had my son and didn't quite understand what mental health was. I just knew I was having grandiose ideas and I wasn't myself. And my husband at the time knew that as well. So he sent me to mental health behavior hospital. And at there I was diagnosed with bipolar, with mania, schizoaffective disorder, and a little anxiety. And I was still kind of in a denial stage because I didn't want to be associated with having a mental health condition. So I didn't take the medications that they prescribed, and I didn't do that for a long period of time. I didn't take the medication for about eight years or so, and I was fine. I was just living my life. And then my grandfather passed away, which caused me to have a psychotic episode. And at that time I was having grandiose ideas and ended up on a 10 13, which in Atlanta, Georgia or the state of Georgia is the code for police officers that somebody's in a psychiatric crisis.

Dr. Ken Duckworth (17:57): That must've been traumatic. Yeah.

Elisa Norman (17:59): It was, it was,because I had never been in trouble before and I was put in handcuffs and put into a police car and was driven to the hospital. And there they put me on a 72-hour hold and I was then diagnosed with having bipolar with mania, schizoaffective disorder. And I still, even though I was hospitalized, still didn't want to have the association of having a mental health condition. So I took the medication for about a month or so and I was feeling fine and took myself off the medication and this was my process for about four or five years. I would go to the hospital, take the medication for a couple of months, feel fine, and then take myself off the medication, not understanding that the medication was the reason why I was feeling fine.

Dr. Ken Duckworth (18:59): That's a hard thing for people to learn. Let's develop this idea a bit that you just did not want to be associated with it and that's why you didn't participate in your treatment, not just the medications. It sounds like you didn't go to appointments, you're like, this is too much. I don't want to be associated with this. I certainly can't take this in as part of things that are part of me.

Elisa Norman (19:21): Yes.

Dr. Ken Duckworth (19:23): So how does that attitude come to pass? Did you watch the same movies that Drea did? Was this part of your culture or was it simply you're in your family system that wasn't okay?

Elisa Norman (19:35): Well, I have watched a movie that Drea has watched, Soul Food, and know about the Uncle Pete situation, and that's kind of like in my family, there was no one had a mental health condition and all I was heard throughout my years was pray, go to church. If you have a problem, go to church, pray it away. And that was some things that I tried when I first was diagnosed and it didn't work for me.

Dr. Ken Duckworth (20:10): Yeah, it's interesting. I think we're getting to a place, and certainly I heard this from some people that I interviewed for NAMI's first book that you can go to church and participate in your treatment, that it's not an either or equation. Is that what you've come to see as well?

Elisa Norman (20:28): Yeah, I've come to that realization now. I do go participate in church now as well as my treatment plan.

Dr. Ken Duckworth (20:37): It's interesting. You and Drea both described changes, role changes when her children left the house, when you lost your grandfather, when you had a baby. These are profound life events that all seem to impact you. How do you think about it now as you look back on it?

Elisa Norman (20:59): As I look back on it, that could have been a trigger for the situation in a sense. And now that I have come to accept the fact that I live with a mental health condition, my life has been a lot better.

Dr. Ken Duckworth (21:18): Do you feel comfortable talking a little bit about how your diagnosis has helped to shape the life you've made?

Elisa Norman (21:27): Yes. My diagnosis, I just make sure that I am able to help other people that are going through that are in denial like I am. Believe it or not, there are a lot of people that feel the way that I did and when I go and talk at certain facilities in our own voice for NAMI, I meet a lot of people and they won't say anything during the presentation or when we have question and answer, but after the presentation they'll come up and say, well, I have this, or I appreciate you talking about this. I thought I was alone in this situation. And I think that that has kind of helped me in my journey.

Dr. Ken Duckworth (22:13): Let's talk a little bit about your mental health providers. Did they play a role, positive or negative in your journey of acceptance? Because it sounds like for you, acceptance that this was part of your life was important.

Elisa Norman (22:27): Yes. Well, the physicians like the psychiatrist for me, it seemed like I was kind of like a number for them and they weren't real personable, but my therapist has played a big, big part in my recovery process. She's very attentive. She listens and I feel like she has put effort in caring about how my day and how my week is going and how I'm doing dealing with a mental health condition. And it really helps me feel like she's on my side through this walk that I go through.

Dr. Ken Duckworth (23:10): Again, back to this idea of the therapeutic alliance that she's with you walking by your side. Have you had any unfortunate or negative experience with providers? You mentioned that you had been hospitalized involuntarily with police and you said handcuffs. That sounds pretty traumatic. Any other adverse or traumatic experiences that have been part of your mental health experience?

Elisa Norman (23:38): Yes. One time I was actually taken to jail for my mental health condition and that was very traumatic and I know now that's not a place I want to be. That's right. I don't understand how anybody could be in that setting and not have a mental health condition because of the traumatic, the trauma that comes behind that. So that was very traumatic for me.

Dr. Ken Duckworth (24:09): A lot more people with mental health conditions end up in correctional settings than in hospitals, given that we have disinvested in hospitals in that infrastructure. Tell me a little bit about how you spend your days now. What do you do with your days? I mean, you're living with a condition, you're living well. What are some of your activities that you engage in during the day?

Elisa Norman (24:35): Well, I do a lot of journaling. I'm also writing a book and I do a lot of speaking engagements with NAMI and I try to just stay busy. I keep up my house and take care of my children, so that keeps me busy.

Dr. Ken Duckworth (24:58): I'll say that's a full life. Tell me about the book you're writing.

Elisa Norman (25:02): It's actually about my experience in the hospital and the things that I endured in lights that maybe it'll help some physicians as well as the people that have gone to the hospital understand what actually takes place because the doctors are only there for a certain period of time. They're not there 24/7, so they don't know what takes place. And if you don't know, you just don't know. And maybe this will open their eyes to see, okay, maybe we need to make some changes. And then for the individual that's been in the hospital, maybe it'll help them to see, well, she was in the hospital but she's living successfully in recovery. I can do that too. If I can do it, maybe they can do it.

Dr. Ken Duckworth (25:47): What's the book called?

Elisa Norman (25:49): It's called Stop Calling Me Jesus.

Dr. Ken Duckworth (25:55): Tell me about that title.

Elisa Norman (25:58): That title is because I've had grandiose ideas and it's amazing how I can remember when I'm in the manic state that people were calling me. They were saying, well, you can't do this because Jesus did it. And it's like, stop calling me Jesus.

Dr. Ken Duckworth (26:22): Got it.

Elisa Norman (26:23): It's interesting.

Dr. Ken Duckworth (26:25): Drea having listened to Elisa, did anything she said, activate any other thoughts for you?

Drea Landry (26:35): I am in total agreement with everything she said. I like what she said. Stop calling me Jesus. Actually, there's a running joke in my family because I had been known to do just about anything that if I tell you I'm going to do something, expect it, it doesn't matter how grandiose or how off the wall it is, know that I have pulled it off simply because I have been known to do things like that.

Dr. Ken Duckworth (27:06): And Nikki rashes is here from her home in Illinois. Nikki works with me at NAMI where she's the Senior Manager for Programs and Digital Training Delivery. But what you need to know about Nikki is that she's really made herself a life mission of being a volunteer educator, peer support specialist and teacher. Hi Nikki.

Nikki Rashes (27:27): Hi Dr. Duckworth.

Dr. Ken Duckworth (27:29): So let's talk a little bit about your mental health journey as you've thought about what Drea and Elisa have had to say about their experience.

Nikki Rashes (27:39): My journey was a little bit different in that it goes back as far as my memory. When I was a young child, I remember lying on my mom's bed just crying and crying and she would ask me what's wrong? And I'd always say, I don't know, I just feel sad. So I never had ---

Dr. Ken Duckworth (27:59): How old are you now when this is happening? How old are we looking at?

Nikki Rashes (28:03): Oh, probably about four years old.

Dr. Ken Duckworth (28:06): Four years old.

Nikki Rashes (28:07): I was always considered oversensitive. I was a moody teenager, I was hormonal. There was always an excuse and things really got bad when I was finishing up high school, I lost my two grandfathers and a close family friend all within three months of each other. And it was something I couldn't bounce back from. The average person, it would definitely be traumatic, it would be difficult, but life would continue. For me, it just became a constant question of why bother? Why am I here? Why are they not? And I was getting ready to go off to college. I started college and things just kind of shot downhill. I went into a very deep depression. I was finding myself on the phone, crying to my mom all the time, trying to come up with excuses for why I felt so sad and they never really measured up. I eventually started experiencing symptoms of mania mixed in with the depression. And when I was 19, I finally got my diagnosis. I went to a psychiatrist for the first time and I truly didn't understand that what was going on with me was not typical. I did not think there was anything wrong. This is what my life was.

Dr. Ken Duckworth (29:39): Don't you think it's really hard when just an n of one? You're just you. We all normalize our experience. Don't you think?

Nikki Rashes (29:47): Absolutely. When I was 16, I started driving and I had a fear of driving because I was constantly having these thoughts in my head like, oh, what if you just jerk the steering wheel and drove off the road? And that would be the end of it. Life would be over, it would be fine. And I didn't realize that other people weren't thinking these things. It just seemed normal and it is. It's very isolating. It's very scary. And yet somehow we assimilate to it and feel like it's just what's supposed to happen in our lives.

Dr. Ken Duckworth (30:25): So you get a diagnosis and you would have the depressive episodes before that, then you had some mania symptoms, you get a diagnosis. And what was that like for you?

Nikki Rashes (30:38): The diagnosis was both a positive and a negative for me. The situation itself was challenging. I went to a psychiatrist really because my mom had asked me to and I knew she loved me and I was going to humor her. So I went to my first psychiatrist, they listened to the family history, they listened to my symptoms, diagnosed me with bipolar disorder, gave me an antidepressant and said, okay, well let me know how it goes. And I walked out the door, no follow-up appointment, nothing. So when you have some bipolar disorder and start throwing in just antidepressants, that was not a pretty cycle.

Dr. Ken Duckworth (31:22): That can be a very risky pathway.

Nikki Rashes (31:25): And at the same time, hearing those words, bipolar disorder, it was like, okay, this is something real. This is not just me being strange. It made sense. So it was nice to have that diagnosis just to have a feeling that, okay, this is a medical condition, so let's go about fixing it now

Dr. Ken Duckworth (31:49): People study this. This is being researched. Millions of other people have it. I'm not alone. Is that kind of where you're going?

Nikki Rashes (31:57): It was the start of that. I still felt very much alone. I was looking at family members who were undiagnosed, who were not getting the treatment they needed and not living the lives they wanted. So that made me in a way feel like what was the point of trying to live my life? I was never going to go anywhere.

Dr. Ken Duckworth (32:21): You hadn't seen anybody in your family integrate this into their experience and move ahead, is that what you're saying?

Nikki Rashes (32:28): Exactly. And that was I turned to books. I started reading every memoir I could get my hands on because I just wanted to find someone who was like me, someone who had made it to the other side, who I could relate to and still see like, okay, they found success. And I finally did find that person in my life. It was when I was working at a religious school and I had to step down partway through the year because of my symptoms being too strong. And I went to my religious school director, did not plan to tell her the truth somehow it just spilled out. I have bipolar disorder, I can't control it. And she just looked at me and said, it's okay, Nikki. I do too. And I was like, okay, she is married ---

Dr. Ken Duckworth (33:19): Just like that.

Nikki Rashes (33:20): Yeah, it was like she has a family, she's married, she's successful, she's happy. How is that possible? And that was a huge shift for me.

Dr. Ken Duckworth (33:29): How old were you then, Nikki?

Nikki Rashes (33:31): I was about 22.

Dr. Ken Duckworth (33:36): So you're young, but you've met now a role model.

Nikki Rashes (33:39) Exactly.

Dr. Ken Duckworth (33:41): And did you continue to be part of that faith community? Did that deepen your interest?

Nikki Rashes (33:47): Yes and no. I had some animosity towards the community when I was first diagnosed, or actually I think it was before I got my diagnosis, when I was first experiencing a lot of symptoms, I was part of the Jewish faith. I went to my rabbi, explained what was going on, asked what I should do, and was given a book about spirituality and told, read this, it'll give you the answers. And they just weren't there.

Dr. Ken Duckworth (34:18): Well, that's a familiar theme, isn't it? Yes. The idea that there's many ways to understand life and faith and medical stuff, but some people approach this as either or, and it sounds to me like all three of you have approached this as both and.

Nikki Rashes (34:36): Yeah. I finally found my way back to my faith. There was definitely a hiatus, but I did come back to it and I did. Or I do find comfort in it. I don't consider it a cure or even part of my treatment, but it is something I find comfort in.

Dr. Ken Duckworth (34:56): When we talked before, you told me your mother was your hero. How has she figured into your experience?

Nikki Rashes (35:03): My mother is 100% my hero. She has been my champion throughout my experiences. She was the first one who recognized there's a lot going on in our family. Maybe Nikki could be going through this experience too. She sat me down and talked about our family history. I had an uncle who I'm very close with, who is doing very well today, but back then was not receiving treatment. And he was crazy Uncle Larry, we loved him. He was fun. He was the cool uncle who let us stay up all night, but he also disappeared from our lives for periods of time. And that's when he was going through extreme depression. We didn't understand that. So she helped me to understand that I came by this, honestly, it was a medical condition. She has supported me to the nth degree, to the point that there were times, I use the term I get stuck where my anxiety becomes kind of crippling and maybe I haven't left the house for a few days. Mom would show up at my house, she would take me by the hand and say, okay, let's do this. We've got this. You're going to come with me and I'm going to support you through the whole thing. And that got me moving again. She helped me, for lack of a better word, get unstuck.

Dr. Ken Duckworth (36:35): Let's talk about your role in your family that you've made and how this experience is part of that, if you're comfortable with developing that idea.

Nikki Rashes (36:47): Sure. So today I am married and have three stepchildren, two grandkids, one on the way.

Dr. Ken Duckworth (36:55): Congratulations.

Nikki Rashes (36:57): Thank you. I have found my own family and I try to be to them what my mom was for me or has been for me with my step-children. Well, to back up, I really didn't think I ever wanted to have children. I thought it would be too hard if they had a diagnosis for me to watch them go through what I had been through. Lo and behold, I get married, my stepson goes through an extreme depression. My stepdaughter has anxiety that she takes medication for. There were a lot of challenges going on in my family for quite a bit, and I found that it was almost like speaking a different language. I could speak their language. So my stepdaughter comes home crying hysterically very upset because she's hungry and we're out of Pop-Tarts. (37:56): This was life crisis in her mind at that moment. And being someone who has lived with anxiety and depression, I knew that those pop-tarts had nothing to do with it. So she was having a panic attack. She's curled up in a ball on the floor in the kitchen. So I lied down next to her and I said, alright, let's talk this through. What's really happening? Let's see what's going on. And it was a language that as much as their father loves them and is an amazing father, he didn't have that experience. So it's helped me to communicate with them in a way that I don't think they would've gotten in their lives otherwise.

Dr. Ken Duckworth (38:36): So you're directly using your own experience to provide an empathic, loving response to your stepchildren.

Nikki Rashes (38:44): Yes.

Dr. Ken Duckworth (38:45): That's beautiful. All three of you have talked about helping other people as central to your journey. Andrea, Elisa, do you want to talk about that a little more?

Drea Landry (38:59): Yes. I was sitting here smiling, listening to Nikki talk about helping her stepchildren and grandchildren. And it just reminded me growing up in a home to where mental health challenges was considered normal, I made it my life's mission to show that treatment is available and possible. And talking to my grandkids who are grown and taller than me, not that that's hard to do.

Drea Landry (39:30): I have a 17-year old grandson who was having some difficulties and he was having suicidal ideation and he says, grandma, he says, this is so not cool. I don't like having to do extra special stuff just so that I could feel good. And I told him, I said, honey, everybody is doing extra special stuff so that they could feel good. I said, that just means that you love yourself enough to know that you deserve to be here and that it's okay. And I helped him learn some other things to help him. And he's just over the moon. So he told me the other day when he came to visit, he says, grandma, I low-key idolize you.

Dr. Ken Duckworth (40:13): The ultimate compliment. I low-key, which means a lot, a lot, a lot, but pretending to be less than that, idolize you. That's very beautiful. Drea. Now Elisa, how about you in terms of your family? You mentioned you're a mother and in terms of your family, have you been able to integrate what you've learned into your parenting?

Elisa Norman (40:36): Yes, because my mother was a psychiatric nurse at one of the major hospitals here in Atlanta, Grady. And she was my biggest cheerleader. She's no longer with us, unfortunately. She passed away three years ago. But she had a style of parenting that was just phenomenal. And I try to instill that with my children and letting them know that I remember one time I had a car accident and I was so nervous to tell my mom I was in an accident and she said, oh baby, we can get another car, but are you okay? And so that's what I want to do for my kids, make sure they're okay. The material things are just that material, but just making sure that they're okay, physically, mentally, that's enough for me.

Dr. Ken Duckworth (41:29): You can talk about mental health as well as everything else in your family, it sounds like.

Elisa Norman (41:35): Yes. I talked to my children about mental health and I explained to them about what I've gone through and what I've been through. Just recently, I sat my daughter down along with one of my nieces, and I just explained to them and they had questions and we had a really good conversation for about two hours. And just to know what they felt and how they materially process the fact that mommy has mental health. Oops, sorry. Yeah.

Dr. Ken Duckworth (42:11): Do you want to finish that thought, Elisa?

Elisa Norman (42:12): Oh, yeah. Well, just so they know that I live and I have a mental health condition, and that is okay, I'm in recovery. I do what I need to do to sustain being in recovery, taking the medication, and going to my doctors so they understood.

Dr. Ken Duckworth (42:32): And participating in the whole life of peer support giving to others. But the idea that you can talk about it is so refreshing. That still isn't happening in every family across America. And I feel like the three of you are such leaders in this conversation. In addition to listening, do you have any other thoughts? This is an open question for the three of you about what a good therapist or psychiatrist should know.

Nikki Rashes (43:02): I think it's important for them to know that we know things. So not just listening, but also understanding that I know how I feel. And when I was stopping and starting those meds, a big part of it was because I was having trouble with how they were making me feel. I wanted to still feel human and be able to live a life. So having someone who can understand that when I'm speaking, I am speaking from experience and I'm speaking with a knowledge of myself. So kind of like Drea said, they have the book knowledge, they have the smarts when it comes to medication. I will never deny that. But at the same time, they also need to recognize that we come in with experience. And the other thing I would say is I have a therapist who absolutely changed my life when I was first diagnosed.

(44:00): And she did that by meeting me where I was. I went to therapy, gosh, probably a couple months I wouldn't speak to her. My mom was sending me to therapy. I would go sit there, she would, okay, she'd ask me some questions. I'd give her some one word answers, and that was the end of it. And I walked in one day, I'm in Michigan, it's dead of winter. I take off my coat. She says, "Nope, put your coat back on." Okay. So I put my coat back on and she says, "Come on walk with me." And we went outside, we go for a walk. And she had that knowledge that when you're walking side by side, you're not looking someone in the face, you're not having a difficult conversation where you're sitting on a couch and someone else is at a desk. And I was able to talk. I was able to open up, and it was that one crack in the armor that got me talking. So just knowing where your patient, client, whatever it may be is coming from, can make a huge difference too.

Dr. Ken Duckworth (45:04): And that was very empathic because she had figured out that staring at you was not going to work, that you were willing to take this to its logical extreme, but that somehow, this is called the bus stop position, where you're both looking off at the world together and whether you're walking or sitting together as if you're on a bus stop, it's a little less difficult for people to open up for some people in those situations. I used to have a child and adolescent practice, and when I saw elementary school kids, the most important part of the work was not my training, it was the Nerf basketball set. Because while we were doing something together, it was easy for them to open up and share with me. But if you were to take that same boy and put him in a chair and have him stare at me, that wasn't happening. Drea, Elisa, any other thoughts you have for what providers or therapists should know?

Elisa Norman (46:00): I think that the providers and the therapists should know that they need to listen to the individual because the individual knows how they're feeling and how the medication is making them feel. And not to say, well, "my books told me that these are the side effects and you're talking about these side effects, and maybe that's not the case." Well, we know our bodies and we know what we're feeling, so they need to listen to what we have ---

Dr. Ken Duckworth (46:32): And if it's happening to you, it's a hundred percent.

Elisa Norman (46:35): Yes, exactly.

Dr. Ken Duckworth (46:35): Even though the side effects only 5% of the time if it's happening to you, it's a hundred percent. Let's talk a little bit about the positive aspects of what you've learned. What is the best thing about living with a mental health condition for you?

Drea Landry (46:54): The best thing about living with a mental illness is I get to be me. I get to explore, I get to do all kinds of things. And I can say, well, yeah, that was me. Or no, I was having a bipolar moment. It also gives me the chance to be someone that someone can look up to, be a good mentor, be a good representative, and dispel the stigma and show my magic, not just my black girl magic or my Drea magic, but just human magic. It's like we are people, we can do it. And that has been the most important thing for me. I am not a someone in that category. I am Drea. Hear me roar -

Dr. Ken Duckworth (47:44): Hear me roar. Let's go.

Drea Landry (47:45): I can do things that I put my mind to.

Dr. Ken Duckworth (47:48): How about you, Nikki? Is there an upside or positive aspect to living with a mental health condition for you?

Nikki Rashes (47:54): Absolutely. At one point, someone had asked me, what's your biggest regret? We were having this conversation and they said, well, I'm sure your biggest regret is that you've had to deal with this mental health condition. I said, absolutely not. It has taken me on a journey to where I want to be. It has helped me live the life I want to live, and it has given me such strength and power in knowing that I can overcome and I can without curing control this illness. And I was several months back diagnosed with cancer, which is in recovery. Everything is fine. But the first thing I thought when I got that diagnosis was "Bring it on." I've had so much thrown at me and I'm doing okay. I'm making my way through it. No matter what comes, I can make my way through it. And that's an attitude I don't think I would've had without the battles I've been through.

Dr. Ken Duckworth (48:54): Well, I'm sorry you went through that medical piece, but it sounds like the resilience that you have learned is your bottom line of living well in recovery. You've learned resilience and you've learned that you can deal with hard things. Elisa, how about you? Any possible upsides to living with a mental health condition?

Elisa Norman (49:16): Yes, definitely. It has given me purpose in knowing what my purpose is here on this planet, because before I was diagnosed, I didn't know what my purpose was. But now that I've been diagnosed, I know that it is to help others. And I'm just fortunate. And I always say, I think people with mental health conditions are superheroes because we have different things that we are trying to accomplish in this world.

Dr. Ken Duckworth (49:47): Drea, thank you for sharing what you've learned in today's podcast.

Drea Landry (49:52): Thank you so much, Ken.

Dr. Ken Duckworth (49:54): Nikki, it was really nice to see you again and learn from you. I want to thank you for being part of this.

Nikki Rashes (49:59): Always happy to be here. Ken

Dr. Ken Duckworth (50:02): Elisa, it was wonderful to see you again and thank you.

Elisa Norman (50:05): Thank you, Ken.

Dr. Ken Duckworth (50:14): This has been The Medical Mind, a podcast from the National Alliance on Mental Illness co-presented by SMI Advisor. The mission of SMI Advisor is to advance the use of a person-centered approach to care that ensures people who have serious mental illness and their families find the treatment and support they need. Learn more at smiadvisor.org. This podcast was produced by Katie Harris and John Moe. We get engineering help from John Miller. I'm Dr. Ken Duckworth and thank you for listening.