Ep 29 - Transforming Anxiety into Growth: Navigating College Mental Health with Lisa Fertel

What if you could turn anxiety into an opportunity for personal growth? Join us on The Angry Biller as we uncover transformative insights from Lisa Fertel, LCSW, a leading voice in mental health for college students. Lisa unveils the unique pressures these young adults face, such as juggling socialization, time management, and self-care, often leading to anxiety and depression. From grounding techniques to creative tools like a rubber band imprinted with "stop, reframe, and breathe," Lisa shares her innovative strategies for managing mental health issues. By focusing on these practical approaches, students can effectively reframe negative thoughts and find balance in their hectic lives.
 
Explore the complex transition from high school to college, and the newfound independence that comes with it. We dive into the critical role that mental health resources, such as therapy, physical activities, and pet therapy, play in helping students manage stress and anxiety. We also tackle the delicate balance of student confidentiality and parental involvement, highlighting the empowerment of young adults to make their own decisions. Delve into the impact of lifestyle choices, like drug use, on academic and career goals, and gain insights into social media's role in exacerbating issues like attention deficit disorder, depression, and anxiety.
 
The conversation broadens to include societal pressures that heighten student anxiety, especially in today's complex political, religious, and social climates. Lisa sheds light on how misinformation and media overload can contribute to stress, particularly as students navigate significant life decisions. Empowerment and safe spaces take center stage as we discuss the importance of allowing young adults to express their identities and engage with societal issues. A compelling success story illustrates how one student overcame marijuana dependency, shining a light on the themes of personal growth and self-acceptance. This episode underscores the foundational role of mental health in overall well-being and the urgent need to prioritize it within our lives.

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Transcript

Josh Fertel

00:04

Welcome to the Angry Biller, a show where we explore the people and the businesses behind the scenes of healthcare, those men and women that are the catalysts that allow providers to concentrate on delivering exceptional patient care. Welcome to the Angry Biller. My name is Josh Fertel, I am the owner of J3 Medical Billing and I am your host. We are at the Visuals by Momo studio. We've done podcasts before about mental health and, luckily for me, my wife came on, lisa Fertel, lcsw, and she spoke about how she treats her patients At home. I hear her talking about college students more than anything talking about college students more than anything. So I really wanted her to come on and go through what she hears and how she handles college students, because it seems to be a real big deal and a lot of her practice is about these individuals. Thank you for coming me, so let's give your background again. 

Lisa Fertel

01:12

We did your background before, but give us your background again, how you got into the mental health field. Well, I think my first job was at Jackson Memorial Hospital, and how I got into it as far as when. 

Josh Fertel

01:24

What led you to it? What led you to cognitive behavior? I just think, being empathic. 

Lisa Fertel

01:28

I think just loving being able to help listen. I'm a good listener Right. I'm wanting to kind of help people move forward, and that's really what you know, seeing people move forward really was very satisfying for me. 

Josh Fertel

01:43

You know, fulfilling their lives and doing well. I know, and again I'm going to give full disclosure, like I did last time, although I did say to you that I wanted to talk about how you help your college-age patients, we did not practice this. You don't know the questions. 

Lisa Fertel

01:57

Correct. 

Josh Fertel

01:57

So don't be mad at me and yell at me when we get home. 

Lisa Fertel

02:01

Spontaneity. All right, let's go. 

Josh Fertel

02:07

Let spontaneity. All right, let's go, let's go. So what are the common things that you're finding when you're talking to your patients? But actually, before I say that you're doing a lot of things remotely, right, well, your patients are remote. How is that? 

Lisa Fertel

02:20

So interesting. I am not remote, I am in my office, but yes. So specifically with college students, yes, they are at their dorm room or they're sitting in their car and just finding space to have a therapy session has been challenging a lot actually for a lot of these kids. I, you know, try to help them get creative getting a study room. They have these depending on where they are finding the time and space, because most of them don't want to go on Right. 

Josh Fertel

02:50

And now they're there. Let's say a month, maybe six weeks, that they've been at school. They're starting to hit their midterms and their finals. The pressures of joining organizations are there for these freshmen. What are you finding is like the common factor? What is it that they're stressing about? 

Lisa Fertel

03:08

Time management. 

Josh Fertel

03:09

Time management. 

Lisa Fertel

03:10

I think that college students want to be social and make friends, especially if they've gone away to school and they're not in a state school from where they're at. So they are pledging fraternities, which is extremely time consuming and demanding at a period of time, as well as classes and understanding the rigor. It's a different challenge than being in a high school where you don't have someone on top of them. So with self-regulation. Some are better at it than others to regulate their time management skills. And then basic needs right. 

Josh Fertel

03:42

You know, sleep yeah. 

Lisa Fertel

03:43

Feeding themselves and laundry, and the things that some are accustomed to and some are not accustomed to. 

Josh Fertel

03:49

Right, right, and so what manifests from there, once they've had all these struggles with time? 

Lisa Fertel

03:55

Well, different things. So, on the psychological part, there's anxiety, there can be depression, feeling that they're having difficulty making friends, that there is, you know, self-esteem issues. 

Josh Fertel

04:07

Yeah. 

Lisa Fertel

04:09

You know eating disorders can come from it. Comparisons and results of that are poor grades. You know being challenged self-isolation can happen. 

Josh Fertel

04:22

Right. 

Lisa Fertel

04:23

Or just the inability to keep up with school. 

Josh Fertel

04:29

And are there warning signs that they may be cognizant of or something that you see, as these things are starting to manifest themselves? 

Lisa Fertel

04:38

Well, you'll hear the word out of people who are anxious fear. I'm scared or I'm worried, or you know these catastrophic fears that are unrealistic. So 99% of things that people worry about are not going to happen. So it's a matter of when you hear these catastrophic fears that I'm going to fail, or I'm going to drop out of school, or my boyfriend and girlfriend are going to break up with me, or I'm not going to have any friends. Those realities are unrealistic. 

05:09

So, those are the kind of catastrophic thoughts, thinking and worries that you see. You know that these kids worry about. 

Josh Fertel

05:15

And so what do you say to them? What's your feedback to them? 

Lisa Fertel

05:17

So always we need to come to present and we practice grounding techniques and learning how to just be present, and breathing techniques to lower heart rate, and I think that when people are starting to feel anxious, it's bigger than they are and they don't know, how to reel it in. So it's practicing, as I say, taking out your toolbox and seeing which tools are more effective than not effective and how you can do that. So there are those things, but there's also exercise and nutrition and hydration and other things that take into account. 

Josh Fertel

05:52

Right, what would be in a toolbox? 

Lisa Fertel

05:54

So I created a red rubber band. I used to give rubber bands to my patients to kind of pull it and to use it as a stop help with framing, and what I noticed is that half of these kids are coming back and they're breaking rubber bands. And then I was going through rubber bands like this. So I created a band and it has my three month rewards for them to use, which is stop, reframe and breathe, and with that I teach them how to utilize that rubber band. They wear it. It's it looks like the bracelets you get at clubs and things. So it doesn't seem not cool or something that people can't that would notice, but it's red and it's their stop sign to stop and ground themselves, breathe and reframe. Whatever negative, worrisome thoughts to see, really are these things that are real. 

Josh Fertel

06:44

And have you had some good feedback from? 

Lisa Fertel

06:47

that any. 

Josh Fertel

06:48

You know the cases that stand out, just said you know, I. I have my rubber band, lisa. Thank you, this is what happened, oh my gosh. 

Lisa Fertel

06:54

Every session I see one of these oh yeah someone's arm is, you know, lifted and they say, you know, this is the greatest thing and it really, like you know, initially, with a stop, you know, I teach them to tap it to kind of ground themselves. And they said now, at this point, it's really just a reminder. They look at it, they see it there and they know it's there and it helps them ground themselves. 

Josh Fertel

07:11

Gotcha, in between the sessions that you have, which are, I guess, weekly or biweekly, what other resources do you suggest to the students that are struggling? Do you suggest to the students that are struggling? 

Lisa Fertel

07:25

So I think it's important that they have someone you know there at school that they can speak to. I always have them go to the mental health resources. I think that it's challenging. Most of them are online as well, so I encourage them to go in there. I think utilizing the gym, yoga, any type of physical activity, going for a walk- Right. 

07:46

I also love a resource that I think you know I like to get creative, but you know most schools will have a veterinary school or some type of practice there or a shelter to go have pet therapy and go and pet and hang out there and feel good with that. But, these are all different things that I think can help soothe and calm people down. 

Josh Fertel

08:09

That's a suggestion. So now you're talking about 17, 18, 19-year-old children. Tell me how the parents, or how you have to interact with the parents now that they're of age, most of them. 

Lisa Fertel

08:22

So I think that's interesting. So when someone becomes legally 18, then I don't have consent from a young adult to speak to their parent. But, most of them are flipping the bill for therapy. It becomes challenging because I can't by law then have that conversation. So I really turn it to the parents, saying it must be really hard not being in the loop of certain things, but that knowing that if something is serious, or life-threatening, then that is when I am able to say something that would not, you know, be negative or implicate anything negative with HIPAA. 

Josh Fertel

08:59

Is it often that one of your patients will say don't tell my parents. 

Lisa Fertel

09:04

I would say 50-50. 

Josh Fertel

09:05

Okay. 

Lisa Fertel

09:05

Because I think that as young adults, they're trying to find themselves, whether it's through sexuality, whether it's through drugs and alcohol, whether it's through choices they're making. I think the hardest thing for parents is seeing your children make choices, not necessarily that they're catastrophic or negative, but they're different or that makes them uncomfortable, right. So when you have that, they don't want to put their parents in an uncomfortable position. 

Josh Fertel

09:31

Right. 

Lisa Fertel

09:32

It could be as simple as a tattoo or piercing that might you know, or dyeing their hair or cutting you know a very different way, that they want that independence and freedom to make those choices. 

Josh Fertel

09:42

Gotcha, and the ones that say it's okay to tell my parents. How does that usually work out? 

Lisa Fertel

09:48

So I don't make calls. These are adults. I say that I think it's good and I encourage you to tell your parents or, if you'd like them, to join us in our next session we can link them together and we can do it that way. With the modern technology you can do that, but I try to empower young adults to be, and parents in general. Once you get to that age, your work is finished. 

Josh Fertel

10:13

And what do? 

Lisa Fertel

10:13

I mean by that? I mean that you have instilled your beliefs and the things that you want to teach your child morals, values, religion and then, at that point, you have to sit back and let this young adult make the decision of what you have taught that they want to take with them. And that's a very hard concept for parents to accept. Not everything that I've shared learned about myself. My kids want to partake or be part of in adulthood. 

Josh Fertel

10:39

Gotcha. Yeah, no, that makes a lot of sense, Is there? Well, I know that you have patients that you've seen through high school that are now going to college. Do you say anything to them in that in-between summer that gets them? These are the things that you're going to need to look out for, and these are the things you need to do a little bit differently. 

Lisa Fertel

10:58

So my role is not to parent. My role is to guide, listen and make suggestions. But, ultimately, that therapeutic relationship is a one-sided relationship. Right, it's me giving and helping and listening. 

Josh Fertel

11:14

Right. 

Lisa Fertel

11:15

But choices and decisions have to be made, and so sometimes you have to hit the low points to grow and make those decisions. For example, on that note, you know a lot of kids use drugs or they smoke pot. From high school they get to college, they graduate college and guess what? They have to go. They want to go to graduate school, they want to go to law school. 

11:34

What I think law school and medical school do they drug test you, so sometimes there's a natural consequence. Oh my gosh, have to stop doing these things because there's ramifications or issues that can come from it. 

Josh Fertel

11:46

Gotcha, let's take a quick break and we'll come back in a couple minutes. I want to talk to you about social media. 

Lisa Fertel

11:51

Excellent. 

Josh Fertel

11:52

Military Recreational Divers is your nonprofit organization that exposes veterans in need to ocean therapy through scuba diving activities. Help our heroes in their healing journey. Support, follow and donate. Today at MRDFLorg, we're back with the lovely Lisa Fertel, happy that she joined us. Again. We're talking about mental health. We're talking about college students. It's a big part of her every day, so I get to see her champion for her patients and she does such a great job. We always have a conversation about social media. I know how you feel about it. Again, when you have a college student who's separated from their family and now all they have is Facebook and other nonsense in front of them, what do you see and how do you guide them through the things that they? 

Lisa Fertel

12:45

see talk about attention deficit disorder, let's talk about depression, let's talk about anxiety, right? So those are the. Let's talk about those three diagnoses, mental health issues, okay, and how social media can possibly affect. So, just like when I have young kids who are, you know, kids that have attention deficit, hyperactive or inattentive, what do they attend to and they can focus on? What? Video games right. 

13:16

So they're gamers, big gamers, and they can focus, but they lose track of time and those kinds of things. It's the same with social media. So with that, one hour turns into four hours to five hours and then you get behind in your schoolwork or in your obligations and things that you have. In that sense, social media definitely has a negative impact because it takes away. You know, if you set a timer and you say, ok, I'm going to go on for 30 minutes and then you can switch back to wherever you are, that can be challenging for kids with that, with depression, I mean. I think that in the fantasy land of social media, you know, we see things that aren't necessarily real and it's the whole thing of that missing out or what I'm not part of. Or look at all these people that have all these friends and are accomplishing so many things and I can't Right. It goes along with body image and looking the way they look. Can't? It goes along with body image and looking the way they look. 

Josh Fertel

14:17

I think that you can get into a very dark hole and drown in emotion, feeling very separated. 

Lisa Fertel

14:20

As much as it can connect us to groups or with people, it also can distance us and make us feel very alone. So, I will see kids with that. And again time about taking a break from social media, reading, painting, finding other outlets that are going to help the depression versus make it bigger. 

Josh Fertel

14:43

Right Make it deeper. 

Lisa Fertel

14:46

Where you're self-isolating. 

Josh Fertel

14:47

Yes, yes. 

Lisa Fertel

14:48

Most college students are in their dorm rooms self-isolating on social media. They're not out at a park, they're not out doing it. Yes, yes about. It's about worrying. Anxiety is all about worry and things that we can or cannot do. It's not just about that. It's things that are going on in the world. They are amplified. You have a lot of different media sources and unless you fact check them, you don't know what's the truth and what's not the truth at a young age. 

15:28

And it's very overwhelming for young people that are trying to figure life out and politics, religion, war, big ticket item things that are happening and that they're relying on social media to solve those problems for them. So it's very anxiety producing and then, depending on what you are getting involved with, it's very anxiety producing and then, depending on what you are getting involved with, you know there are those caches where that when you click or like something, then you're going to get in your feed more of that Correct. So it does create a lot of anxiety and stress for young people as well, as well as adults. But since we're talking about college kids, you know they don't have that person to bounce off of. 

Josh Fertel

16:11

Okay, so let's talk about now the biggest thing, and you touched on it what goes on at college campuses over the past year and is currently going on in the future. When we're talking about politics, we're talking about religion, we're talking about war, which you just brought up. What's your experience been with your patients that are involved in these epicenters in Columbia, Penn and these other schools that have had all this disruption? 

Lisa Fertel

16:35

So you know I'm going to speak on facts right, because everyone has opinions, so I don't. 

16:42

I think it's important not to give my opinion but to give facts and what I have seen from my patients and I think that the Ivy Leagues have had probably the most disruption, anti-semitism and very stressful environments. 

17:00

And you know where does it come from and a lot of it is where monies are coming in and being filtered and where they've been put into the universities that have swayed certain opinions Right. Where I have seen really as far as like the Florida schools because I do see a lot of kids from Florida, florida State, university of Florida the support and the resources and the lack of tolerance for hatred, for any type of hate group, has been mitigated immediately. Where, unfortunately, it took a very long time for the Ivy League environment and we're talking about Harvard and Columbia and University of Pennsylvania and all of the schools that really took a long time to act on hate, there should never be any sitting. I think that as soon as we see hate or misrepresentation here's my opinion I think that it would have benefited these students feeling supported and feeling that they were safe, because to me it's heartbreaking to see kids who are going to an environment to learn, to study and not feel safe because of other students coming out of their mouths. 

Josh Fertel

18:16

And then how? How did that? How did you handle those situations when they told you about what was going on, how they felt? 

Lisa Fertel

18:23

Well, I can tell you, the one thing is to not be fearful, speak up, and speak up safely, and which avenues they have to make their voice heard, and I think anyone in numbers can feel safe and peacefully protest. And to speak up speaking to administrators, speaking to your local government the squeaky wheel gets the grease Right, right. So if you don't feel safe and campus police don't help you feel safe, then the local police don't help you feel safe and administration. You keep going up the chain until you're heard. 

Josh Fertel

18:59

Right. 

Lisa Fertel

19:00

But you know the biggest, you have some students who want to hide and hide their identity, and then you have others who are loud and proud and it's finding the fine line of being safe and being heard and me empowering them to speak their truth. 

Josh Fertel

19:15

Right, and this goes beyond religious or political ideologies. 

Lisa Fertel

19:22

This goes like skills. 

Josh Fertel

19:24

Right. 

Lisa Fertel

19:24

That honoring yourself and giving yourself grace and speaking up and feeling safe doing so, and, whether someone accepts you or not, that you accept yourself first and the rest happens after that. 

Josh Fertel

19:39

But the important thing is to just speak up, whether it's to your administration or to somebody like yourself, where you can just hear yourself heard, and then you can get this stuff off your chest. 

Lisa Fertel

19:51

And it seems so logical for you and I to sit here as adults in our age group. But 19, 20-year-olds, what is their biggest priority is to fit in, to be accepted. So if I speak against where my friends or other people, then I'm going to be alone, and that's what's so hard with young people who are 17, 18, 19, 20 years old. 

20:21

They want to speak up, but they don't want to lose their friend group or be ostracized from any of the groups that they're involved in or sports groups they're involved in. Acceptance is really an important thing for young people. 

Josh Fertel

20:32

Right, right right. 

Lisa Fertel

20:33

To feel connected. So give me a good story Give me a good win that you've had with one of your patients. 

Josh Fertel

20:48

Anything. One of the college ones. 

Lisa Fertel

20:51

Right In this specific topic. 

Josh Fertel

20:53

On any topic that they've come to you and this was their issue and you gave them their toolbox and you saw a big change. 

Lisa Fertel

21:04

Well, I have another story. I started seeing this young man 15, 16, and is now in his late 20s. Okay, and I laugh, because he was fighting me from the beginning about smoking marijuana which is a hot topic in my office that everyone wants to smoke and obviously my stance is that it's not productive when it's affecting your life. And I say successful because life experiences and life changes. You know he's been about a year clean. 

Josh Fertel

21:40

Right. 

Lisa Fertel

21:41

And you know I listen, there's no judgment. And he said wow, if I listened to you so many years ago when I was in undergraduate school or in high school, and I said but you had to go to this journey and feel the difference to where you are now, that you're feeling, you know, more clarity and you feel your memory is sharper and that you know you lost weight because you're not, you know, eating the things you want to do. And he got his dream job. Guess what they do at his dream job. 

Josh Fertel

22:07

What do they do? 

Lisa Fertel

22:08

They drug test you. Oh, that would have been a big problem. So the fact is he's being successful, he's doing well, he's really happy. 

Josh Fertel

22:17

Yeah, good. 

Lisa Fertel

22:18

And I love seeing him thriving and doing well. 

Josh Fertel

22:20

Oh, that's awesome. No, that's a great story. Thank you for your time. Thank you for coming in. 

Lisa Fertel

22:45

I really wanted you to come in and speak about what I know you are awesome at. If I had a magic wand, if I gave you the magic wand I've asked this before and you can do something to help your college age patients what would you do? So I think that the mental health there has to be a better connection with wherever they are school-wise and if it's on a campus that they feel safe to go there, that it's accessible. I love that I'm seeing now that they are offering an initial telehealth, because sometimes kids don't want to go in so they'll do their initial telehealth with the schools. So just continued focus on understanding that mental health is, if not just as important, more important than the physical health, because if you don't have your mental health, yes, that's where it all starts it begins there. 

Josh Fertel

23:24

Thank you again for coming on. I guess I owe you a dinner, and we will do this again when I think of something else that I want you to preach about. 

Lisa Fertel

23:33

I'd love to come. Thank you for having me. 

Josh Fertel

23:35

Thanks. 

Lisa Fertel

23:35

Okay. 

Josh Fertel

23:37

Thank you for listening today. Please follow us on Facebook and LinkedIn, and you can check us out at theangrybiller.com.