S1: E35 Grief and Loss - Anxiety and Depression with Katy Moyer

Season One
Episode 35
Grief and Loss - Anxiety and Depression with Katy Moyer

Katy Moyer is a Licensed Professional Counselor Associate at LifeCare Counseling and Coaching in Raleigh, North Carolina.  She is also a member of the American Association of Christian Counselors.  While her areas of practice include anxiety, depression, grief and loss, women's issues, relationship issues and life adjustments and transitions, she has a special interest in working with clients who have experienced pregnancy and infant loss, including marriages and stillbirth, as well as primary and secondary infertility.

TRANSCRIPT OF THE SHOW

Jessica:  Can we kind of dive into a couple of more, I'll say more specific areas, kind of starting with anxiety and depression because it is more common.  In fact a couple episodes prior to this one, I actually shared my story of how I've dealt with anxiety and depression and how that's affected my outlook and just the things I've gone through and it just seems to be pretty incredibly common and I feel like, just like you were talking about counseling becoming more comfortable for people, that we've become better as a society about talking about anxiety and depression.  How does anxiety and/or depression manifest itself and what symptoms would we notice kind of in a general sense?

Katy:  I would go as far to say that anxiety is an epidemic.  You know, for a while I think that there was a lot more depression, but we're kind of seeing this shift of like a lot of anxiety.  Like a lot coming into my office.  Like I would say that's the majority of my clientele.  And even if that's not specifically what they're coming in for, they have anxiety tied to something else.  Here's the deal:  we have, when we look at anxiety, we have environmental anxiety and that environmental stress. And basically everyone is dealing with that.  That is societal.  That is cultural.  You know, I always say that God never intended for us to live this kind of pace.  This kind of life.  There's so much noise.  There's so much coming at us.  There's so many expectations.  There's just there's so much stress.  So that's that environmental side of it that I think that we're all as a culture feeling right now.  Right?!

Then you have someone who maybe they're, biologically, there is something going on, where it's that chemical imbalance in their brain where they're like 'this is something more than I'm feeling stressed about my job.'  That sort of thing.  For those people, I feel like they're getting that double dose because not only do they have that clinical aspect, but on top of it they're getting the environmental stress or anxiety too. 

I think about kids coming in too.  I don't see adolescents or children.  I usually - the youngest I've gone is like seventeen or eighteen.  I do see a lot of college students though coming in.  Just the amount of pressure that they have on them, it's just incredulous and so much more and not just the academic aspect of it, but through social media into it and it has blown up our mental health.  Just blown up.  So that level of anxiety I've just seen skyrocket.

Even though we look at anxiety and depression as two different disorders, we know that they're two separate disorders.  A lot of people will come in and they're like, 'I don't know if I'm feeling anxious or depressed.'  And I'm like, 'Probably both because they're like BFF's.'  They like to play off of each other because you start to feel anxious and you have those feelings of guilt and shame and then you're feeling bad about it.  And then you're feeling sad about it.  And then you're feeling down.  And then you get into this kind of vicious cycle that it's like playing back and forth.  This ping pong between depression and anxiety and that is extremely common as well for people to think that they have one thing and kind of identified as something else.  Or a little bit of depression with anxiety.  So it's very common to kind of see those in the same picture like clinically with the same person.

If I talk to somebody and based on their symptoms I was seeing something like yeah, this is probably more like this is clinical anxiety as far as generalized anxiety disorder, you know, some of the things that I would see is that they always feel really keyed up or on edge.  Feeling irritable.  Difficulty concentrating.  I'll have people come in and they're liked 'I have so much up here in my head that I just can't.  That it's just extremely overwhelming for them.

Sleep is a huge indication of something with clinical anxiety because if you're feeling anxious it's hard to fall asleep, but if you don't get enough sleep, it exacerbates anxiety.  So that is usually a pretty good indication that there might be something with some clinical anxiety with that.  

As far as with depressive symptoms, loss of interest in previously pleasurable activities.  That sort of thing.  Withdrawing from people.  Loss of energy.  Weight loss.  Either insomnia.  Hypersomnia.  So you're like I can't go to sleep or I'm sleeping all the time and I can't get out of bed.  And then oftentimes, if there are any thoughts of suicide or suicidal ideation, I'd be like that's probably leaning more towards depression.  And so yeah, those are kind of the most common things - symptoms that I would see as far as coming in with either anxiety or depression.

Jessica:  What do you think are some practical things that we can do when we have - I'll say moments of anxiousness or depression only because it's going to vary depending on the person and their situation and how often they're feeling this way and that kind of thing.

Katy:  Sure.  Yeah.  And so obviously I'm a huge proponent of going and seeking counseling and king of getting that help and getting that objective help especially when it's beyond our scope of being able to cope with it.  But I'm also a huge supporter of clients who decide to take medication for it.  I fully realize that it's not for everybody and I have people who come in and are like 'I am not taking medication.  I will not do it.'  That's fine.  I'm totally fine with that.  I do think that they can work very beautifully together especially when it comes to anxiety or depression.  Supporting them through whatever they decide to do.  So whether or not it is just counseling or counseling in conjunction with med management and that sort of thing too.  Those can be some really great starting points for that.

I would say, practically speaking, about some things that we can do when we are having those moments of anxiousness or feeling kind of down or what we would describe as depression, I'm really big on creating mindfulness and having mindfulness practices that we can use.  And so of course that kind of runs the gamut.  That means anywhere, anything from meditation and prayer and breathing or visualization exercises, muscle relaxation, yoga.  I love bringing other resources into it as far as - 

Is there a book that I can read?  

Is there a workbook that I can use?

I'm such a book lover as it is.  Of course like my undergrad I have an English Lit Degree and so I love to read!  I love using bibliotherapy.  I love when I can incorporate like really good books and workbooks that are able to fuse into that.  And then also like technology is awesome.  As we discovered earlier, it's sometimes a pain in the butt, but technology is really great too and there's some pretty great apps that they've come out with.  And the one that I most often will recommend to clients is called Calm.  Of course there is the free side of it, but the paid side of Calm is pretty fantastic.  There's some really great meditation exercises, relaxation, music.  And I think that even for those people who might, when I say meditation some Christians are like '(gasp!) that's like Voodoo.'  You know part of meditation is what are we setting our minds on?  Like I think that we can use those tools without it saying like it's the tool of Satan or something.  But there's a lot of really great resources that aren't necessarily faith based, but that we can use and can be very helpful.

Jessica:  You know, I shared my story like I said on a podcast like a said a while ago.  I'm on medication and I've been on medication for several years, but I also know I need good sleep.  That's a huge one.  And I also need, for me, I need some Vitamin D and I need to go outside and do something  in the sunshine whether it's running, you know, I walk my dog a lot.  But it's like, if I know those things and even when I'm feeling really down, if I can get myself to just go do those things, I feel so much better.

Katy:  Yeah absolutely.  It doesn't have to be like this really therapy type of tool.  It can be moving your body.  Like when I'm talking to somebody, I'm like what does your physical activity look like?  You don't have to go to the gym every day, but you can go out and take a walk.  Because we know- there's clinical research that shows that that definitely can improve mood.  That definitely helps.  We know that how we fuel our body makes a big difference too.  Of course I'm not a nutritionist.  I'm not a dietician.  I can't give that advice, but I can say 'hey, most people can kind of see the connection between if I drink Diet Coke and eat Cheetos all day, I'm going to feel pretty cruddy.'  So what I'm putting in my body, yeah absolutely, that's going to impact my mood.

Even some of those very simple things that we have control over and that we can do and that are very practical, I think that's fantastic.  Yeah, Vitamin D.  I'm right there with you girl.  Yeah, that's so therapeutic for me.  That's so important and for me personally, I have to workout.  That is part of my mental health.  That is part of what we need to do.  And so I think you're absolutely right.  Find what works for you and then go do that thing.

Jessica:  Just doing it and getting in that habit of doing it, for me, it has been really, really great.  What are some signals that tell us that it's something more than just like I'm anxious about a test or I'm really sad about this thing that's happened and that it's something we need to discuss with a doctor or with a counselor?  Only because you talked about the environmental stresses and there are those and those can definitely be very challenging, but just distinguishing between like healthy levels of stress that we encounter every day compared to things where it's like okay - we definitely need more help.  Does that make sense?

Katy:  Yeah absolutely and I do think it's important to kind of distinguish between those two things because there are healthy levels of stress.  And it's okay.  I think that that helps us to push ourselves.  It challenges us.  It helps us to actually get motivated to do things. You know, having a little 'okay, I'm feeling a little nervous about this or a little anxious about this,' that's okay.  That's completely normal.  But really it's knowing, you know, when somebody comes in, I need to know what is your baseline.  So where do you normally live?  When you are not feeling like you're feeling right now, where do you normally live?  So that would be your baseline.  So if somebody comes in and says, "Well I normally live at a three."  Okay.  Okay.  I'm normally at a three.  There's like maybe I have a little bit of anxiety, but I can handle it.  I can handle it.  And they come in and they're at an eight.  Okay.  Then that's a pretty good indication that, you know, it's something else.  It's something more than they're able to do.

Also we kind of look at what is the severity of it.  

What's the severity of it?  

What's the onset of it?  

How long have you been struggling with it?

What have you already done that maybe has worked or hasn't worked?

Really though it's kind of that self, you have to self-gauge of what is - okay, what is going on in my life?  Is this just a season that tends to be really stressful for me?  Is this, okay, telling myself that I know it's not always going to be like this.  I know this is just right now.  I haven't met my threshold yet.  I think I'm good.  Like I think I'm good.

You know, but when it starts to kind of tip over the other way, you might be like 'eh, this might be a little bit more than I can handle.  And I think for the most part that people know if it's gone beyond like the 'I'm just a little bit stressed about work' to 'I am so paralyzed I can't get anything done at work.'  So just kind of gauging for yourself - what's my normal?  What's my baseline?  And then, where am I at?  Where am I at with that?  If that makes any sense.

Jessica:  Yeah.  It does.  It does.

Katy:  We're in a refining process anyway.  We know that.  Part of that refining process is kind of like evaluating where you're at and being aware of where you are.  And that's part of growing and changing and doing all those things and so that'd be a pretty good indication of like 'eh, something's off.  That's something a little bit more than regular stress.

Jessica:  So anxiety and depression being, that's one area that you focus on in your area of practice and then the other ones that you have focused on are like women's issues, relationship issues.  And then the other two that I would just like to touch on are grief and loss and then life adjustments and transitions. And I got your approval before we share or you share your story.  I just want people to know that so this isn't like coming out of the blue at you.  But with grief and loss being a huge part of your counseling practice and honestly just your ministry to other people, can you kind of share about what you've experienced in terms of the - you talked a little bit about it the last, when we talked earlier about having a significant loss.  Can you kind of share your story about that and how you walked through that?

Katy:  Yeah, yeah.  Sure.  Of course.  Just to kind of give a little bit of background on me personally.  I've been married for going on 18 years.  Yeah, I can't.  Together for 19 years.  Have two sons.  My oldest son Mason, he's fourteen.  We're getting ready for high school.  JV Football.  All that really, really fun stuff.  And then my youngest son Robert.   He would have been eleven next month.  August 21st.  And I say would have been because he died in 2008.  He was stillborn so that was definitely that significant loss that I was alluding to.  We had no indication that there was anything wrong with our pregnancy.  Pretty normal pregnancy with things.  Just like a lot of other women and couples that I've talked to, it's one of those things where you just go in for that routine appointment and you hear those words:  there's no heartbeat.  And so you...this... your world implodes basically.  And you're having to make these split-second decisions about things that you never imagined would possibly be happening because you had this life planned of having a family and adding another child and giving your son a little brother.  And then those things just don't happen.  

And so went through that painful process of going home and getting my hospital bag and coming back and being induced and still going through twelve hours of labor and going through that whole process, but basically having to birth his death.  And that is... that's something you can't prepare yourself for until you're actually going through it.  And I mean, I can say without a doubt... I mean I've obviously gone through some really traumatic things in my life, it was by far the hardest thing I have ever had to do.  It was absolutely devastating.

So yeah.  That was kind of experience with that and not just that experience of birthing my son and spending time with him and then the most heartbreaking thing for me was leaving the hospital without him.  Like you're, most moms after we have our babies, we're rolled out of the hospital in our wheelchair and we're holding our baby and I had nothing.  And so that was absolutely devastating.  And so then you have to figure out like what am I going to do with this?  Like what does this mean?  And probably even before that, you are just trying to...you're in shock.  And we can go back to like those stages of grief.  That sort of thing which I use really lightly because I think those are a great reference point, but by no means is that mandated that this is how you're going to feel.  And grief is definitely not sequential.  It's more like this jumbled ball of mess.  But it is, like, what just happened? This is, this is not the way that it's supposed to be!  It was not supposed to be this way.

And then definitely feeling angry.  Feeling angry at myself.  Could I have done something?  Angry at God.  Oh my gosh - absolutely angry with God.  I can fully admit that.  So just kind of going through this process.  And also to distinguish - so grief and mourning are kind of used interchangeably, but they actually mean two different things.  So grief is that internal feeling that you have and then mourning is the outward expression of that.  Through that mourning process of just trying to figure out like, this is my new normal.  I need to figure out what, what this is going to be.

On top of the fact that I am trying to recover after delivery.  I have a three year old son that I'm trying to take care of.  And like life is going on around me, but you feel like you're in slow motion.  Or it's funny because we love Stranger Things here and so to use - and I thought what a great analogy for what it feels like for after you have a loss, but it's like when you're in that (what is it...) the Upside Down World or like the...it feels like okay, this is my life, but it doesn't feel like my life.  And nothing feels the same.  And so it is a very, very strange place to be when you have a significant loss like that.  And so then, from that time, it was a process.  It was this journey that I started on that I never thought I would find myself.  That I certainly was not happy about being there.  Absolute devastation.  Went through obvious, just horrible depression where I literally could not get out of bed.  Where I just cried and cried.  Well, and then of course you're dealing with hormones.  Oh my gosh - your hormones are all over the place!  

It was that time where I was like, I went and had my check up with my doctor and he suggested that like, you know, it's probably not a bad idea if we talk about an anti-depressant.  And I was like, "Yes. Let's just do it.  I need something.  Like I can't cry all day.  I need to be able to function.  I need to be able to at least take care of my son."  And then also exploring like what does it look like to meet with somebody and talk with somebody through this.  And I had seen a counselor before after my parents got divorced.  So I was familiar with counseling.  I wasn't scared of counseling or anything like that.  I just hadn't really used it since then, but I was desperate.  Like I was absolutely desperate.  I was just, I know that I can't do this by myself.  I need to talk to somebody.

That was hard because I struggled to find a counselor that I felt like I could really connect with.  That I felt like they were really at a place where they could walk with me through this kind of loss.  And that's not to say that because if the counselor hasn't experienced it that they can't do it.  Because obviously I have people come in with things all the time that I've never personally experienced, but I'm able to have that empathy and walk with them through that.  Having said that, I do feel like there are some things that people come in with that you just - unless you've experienced it, you have no idea.  Child loss and infant loss, pregnancy loss, that sort of thing I think that's one of those things.  Infertility which is also another one of my specialities because I actually went on to have infertility after this.  And addiction is another one.  I have not had addiction myself, but I'm saying for other people.  If they've been through it, they get it.  Like they really, really get it.  And I think that's what I needed.  Like I needed someone who got it.  And I really struggled to find that.  Like really struggled.  And actually never found someone who had experienced stillbirth as a counselor.  Now did I work with a counselor that was lovely and wonderful and was able to help me with healing?  Absolutely.  Absolutely.  But what I noticed - and that was probably the beginning of this - was there's a gap with that.  There's a real gap to try to find people who are actually specializing or this is a niche area for them.  And so I think even at that time God already started to kind of pave the way and prepare me for like this is a place.  This is a ministry that could be used.  So yeah.  That's kind of in a nutshell - that's my story of how I've gotten to this place of working with grief and loss and working with other women who are experiencing/experienced miscarriage and stillbirth and infertility and things like that.  And I have such a passion for it because I've experienced it.  I know what it feels like.  And of course everybody's grief story is different, but I feel like I am better equipped in order to kind of enter into that pain with somebody.

And the other thing that I'll say about it too is that in general, people view death as something scary.  And we can say that, I would say, without a doubt for people who are not believers because there's that unknown.  But even for believers, like, even if we can rationally know that we will be with Jesus or that our loved ones will be with Jesus, it's really - it's scary.  It's scary.  It's unknown.  We can't go there and experience it and then come back.  It's just a very scary place to be.  And I will say that having experienced the loss of my son, death is not as scary to me anymore.  And it's not that I don't like death, but I'm not scared of death anymore.  I'm a lot more comfortable walking in those places with people.  I'm not afraid to like really get down in the dirt with people when it comes to that.  And so I think that death really has lost its sting for me in that regard.  Of course I don't like death.  I don't want to see people - I don't want to lose people.  But I don't - I look at it much differently.  And then of course, as Christians grieving - we grieve with hope.  And hope makes the huge difference.  When you're able to grieve with hope knowing yes, I miss my loved one.  It's devastating.  It's still something I need to go through this mourning process, but I have that confidence in Jesus and I have that confidence in knowing where my loved one is.  And that really does - it just kind of takes away the scariness.  At least for me.  And so that makes it a lot easier for me to be able to walk with people through that.

Jessica:  Thank you for sharing your story.  I haven't gone through what you've gone through, but I've had friends who have gone through some difficult times in relationship to loss and just grieving.  And sometimes I have handled it really well in helping to walk alongside them and it's like okay, I know I've been there and at others times I can definitely say that I would just either avoid them or I didn't know what to say or I didn't know how to handle interacting and so I feel like for sure did things.  You know, you don't want to say the wrong thing.  You don't want to do the wrong thing.  So if we have a coworker or a friend who is going through a time of grief and loss, what do you recommend as far as things we can do or even say - I always feel like there's not really much you can say, you know - things that are helpful to really go alongside that person?

Katy:  You're so right because along with the part of people being scared of death and scared of grieving and mourning and all those things, they ... I think we're just ill equipped on what we can do and you know, I would say that for me personally, as much as I appreciated people, they would want to come and do child sitting for me or childcare for me.  They would want to clean my house.  They would bring me meals.  Like those were huge blessings.  Huge blessings during that time when I just couldn't even function.  The most helpful thing for me or the most kind thing that people could do with me is those friends who came over, didn't say a word, and crawled up in bed with me.  Or...it makes me want to cry when you think about it because that meant so much more than anything that they could actually do or say in those moments because you're absolutely right like there's nothing that anybody's going to actually be able to say that will actually make it better.  And unfortunately even when people have the best intentions, it can actually end up wounding people a lot more who are grieving.  But the biggest part of walking alongside somebody who is grieving is presence.

(889...To be continued soon)