80. Surviving Teenage Depression + Anxiety: FAQs, Intensive Treatment, DBT, Coping Skills, + More

Dec 27

listen to this episode:

In today's solo episode I tell my mental health story. I dive into my struggle with depression, anxiety, suicidal ideation, self-harm, and more. I also discuss my treatment journey, my experience with DBT, and where I'm at today. I give my best at-home mental health tips you can implement and answer your questions about my journey! I hope this is a reminder that you're not alone!

Mentioned In The Episode…

+ About DBT

+ Dialectical Behavioral Therapy Studies

+ DBT Skills

+ 3East McLean Hospital - Adolescent DBT Programs

+ Ep. 28 feat. Dr. Blaise Aguirre

SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC

Episode Sponsors

🛋This week's episode is sponsored by Teen Counseling. Teen Counseling is an online therapy program with over 14,000 licensed therapists in their network offering support with depression, anxiety, relationships, trauma, and more via text, talk, and video counseling. Head to teencounseling.com/shepersisted to find a therapist today!

🍓This week's episode is brought to you by Sakara. Sakara is a nutrition company that focuses on overall wellness, starting with what you eat. Use code XOSADIE at checkout for 20% off your first order!

☕️This week's episode is brought to you by Nutpods. Shop their delicious Vegan, Gluten-Free, Non-GMO, Kosher, and Whole 30 creamers today and use code 'SHEPERSISTEDPODCAST' at checkout for 15% off your order.

About She Persisted (formerly Nevertheless, She Persisted)

After a year and a half of intensive treatment for severe depression and anxiety, 18-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

Hello, Hello, and welcome to She Persisted. If you are new here, I'm so excited. You're here. If you're a returning listener, welcome back. I'm excited for you to listen to today's episode. We are doing a solo episode, all about my mental health journeys. We're taking it back to 13 year old, 14 year old Sadie.

We're talking about depression, anxiety, mental health treatment, and so many things. We go into a ton of detail and I really hope it paints a really great picture of why I started cheaper assisted and why I'm so passionate about mental health. So not a long intro this week, because you're going to hear me talk for the next hour, but I just wanted to say happy holidays.

I hope you are all having a wonderful week that is filled with rest and relaxation and joyful moments with your loved ones. Um, wherever you may be. So let's dive into it. So, if you have been around on the she persisted journey, you know, that I rerecorded my mental health story.

After I'd recorded 25 episodes, we are now two and a half, almost three years into this journey. And we're at 80 episodes and there's a lot of new listeners here and audience members and people that I haven't joined my mental health journey with. Recently I did a little Instagram story series where I talked about my mental health journey and I've never gotten so many responses to a story or people that could relate or just found it so resonating or didn't know what I had gone through.

And I realized how much I forget that people don't just automatically understand your journey, your perspective, your lived experiences. I think it's really easy to get into the Headspace that your lived experience is the norm that everyone gets it. They understand, they know why you feel a certain way, why you have certain beliefs and that's not, not necessarily the case.

And so that's what I wanted to do today. I wanted to share my mental health journey from start to finish and how it's evolved since I've started the podcast to re-introduce myself a little bit because it goes hand in hand with all these amazing interviews that we've been doing recently. I want to start with something that is really pivotal and DBT. And what unpack with DBT is later in this episode and, and a lot of different treatment modalities, which is the bio-psycho-social approach. And so this is the idea and the philosophy that your mental health and the way that your brain works is impacted by your biology, which is like your genes.

It's how you experience your emotions. It's how likely you are to react to things in different stimuli. - How emotional you are versus how rational you are. Another big thing here, especially for teens is the fact that your prefrontal cortex isn't fully developed. So when teens struggle with mental health, a big component of that from a biological perspective is that they feel their emotions more strongly.

They're not lodging through things as an adult, struggling with their mental health. What, and that's something that we forget a lot of the times. And the second part of the bio-psycho-social approach is a psychology. It's everything that happens in your mind. It's everything that's internal, it's your belief systems.

It's your emotions. It's how you view yourself, your self-esteem, your habits, all of those kinds of things, how you cope with situations. And the last part is the social aspect. And so that is your family situation, your school, your hobbies, everything in your environment that has impacted how you view your mental health and how you experience your emotions.

So a big social part would be if you've experienced a big trauma, that would be a social factor that is impacting or mental health. So for me, when I lay the foundation for my mental health, I always am brought back to when I was a kid. And that I always felt my emotions really strongly. I remember I would be in elementary school, like whenever a teacher is like, can I talk to you?

CDI would like immediately tear up. Or if I was embarrassed, like I immediately would be overwhelmed with emotion. I remember that being something that has always been a constant, I feel my emotions really strongly and I'm really sensitive. So if I had a low day, I experienced that to a larger degree and then another person might

so that was something going into my mental health journey that made me like a little bit more susceptible to experiencing these emotions in a really big, heavy, overwhelming way. We've also been talking a lot in my psychology class. I love bringing in different things that I'm learning while I'm at Penn to the podcast that resonate and relate and totally tie into what I'm talking about.

And we are in the mental illness component, the mental disorders unit. And we're talking about how there's a biological component that can make you more susceptible or at risk to having different mental illnesses, mental disorders, whether that's things like personality disorders, whether that's developmental disorders, whether that's severe depression, there are different things that from a genetic level, from a biological level, put you more at risk, but there's the environmental factor that causes you to experience things to different scales or experience them at all.

And we really don't understand completely where the genetic part is. What happens in an environmental factor? We know that healthy relationships and good support systems decrease mental health challenges, but there's a lot that hasn't been figured out there. But we do know that there's that biological component and there's the environmental component.

So for me, the biological component was at my, my biggest line was just that I was really sensitive. I feel my emotions really strongly in a really big way. And it's always been like that. And then we have the environmental factor, which also added to my mental health challenges.

And so for me, the environmental factor was feeling really invalidated. I had a lot of core beliefs that really led to a very dismal outlook on the world.

When I was a freshman and when I was in eighth grade, when I was really struggling with my mental health, I had a couple of core beliefs that I really lived my life by. I thought that I wasn't deserving of love. I thought that I would never be good enough for my parents and that I was not deserving of being depressed or being this depressed because there was no reason why I should be depressed.

I didn't go through a big trauma. There is no big loss. I was experiencing all these super big overwhelming emotions, but there was no reason why, like, when I looked at the boxes of like, okay, what would make it normal or reasonable or okay. To feel these emotions and feel this isolated and alone and hopeless.

There wasn't anything there. And because I started to experience feelings of depression. So young, that compounded and built to this low point. When I was 13, 14 years old, I didn't have a point of happiness and joy and a life worth living that I could work towards when I started my treatment journey, which we'll dive into it. Wasn't like, okay, I'm working to get back to this emotional point.

I'm working to get back to feeling this way, because I didn't remember feeling happy and loving life and looking forward to things. My norm was feeling depressed and overwhelmed and hopeless. And so I really thought that was what my life was going to look like for the entire rest of my life. And that's really depressing for a 13 year old to think.

But my lived experience was that that was what life looked like. And I could kind of wrap my head around the fact that other people's lives didn't look like extreme depression and suicidality and suffering, but I didn't think that was in the cards for me. I thought I was different. I thought I was the outlier and I really didn't think that I deserved anything different.

And so when you're looking at the world through the lens of not being deserving of love or care and being deserving of depressed and believing that you're meant to be that way for the rest of your life, of course your mood is going to suffer. You're not going to be in a good head space. And that was exactly what happened to me.

I was going through every single relationship, looking for the circumstantial evidence that I wasn't good enough and that I was going to feel this way forever. And so these belief systems. The self-esteem problems. They really just got to a very overwhelming point in all of these beliefs manifested and really different way throughout my life, especially in my relationships to the point where, when I was navigating the world, every single thing that I interacted with just dampened my mood, it took energy.

It was draining. It made me frustrating. I didn't feel seen, I didn't feel heard. And I felt really isolated and alone.

And the more I struggled, the more I looked for different ways to feel validated and heard and understood and loved because that's all that we really want as humans.

We want to feel connected. We want to feel supported what we're wired for. And I just didn't feel that. So as I continue to try and find this validation and this love and support, there was a lot of different behaviors that got introduced. The more I was struggling. When I look back at my depression and my mental health journey. I remember when it first got really bad. My mom jumped in and she was like, we're going to go to the pediatrician today.

We really need support and we don't know what's going on. So I remember I went to the pediatrician, his office and they did one of those surveys that ask you, have you experienced low mood? Have you had decreased interest in activities that you use to enjoy the typical depression checklist and every single thing that he was saying?

I was like, yeah, I have had that. And I remember just starting to cry because. I realized how much these feelings had consumed my life. And I realized how dismal my, my lived experience was. And he said to me, he was like, you're definitely depressed. You're definitely struggling. I, I really do see that. And your mom has made an appointment for you to go to the psychiatrist later today.

And if you don't go to that, you're going to go ahead and spend some time in the hospital. That's not normal. Don't worry if you go and tell someone that you're feeling depressed, they're not going to just that hospital time. But I was really struggling. I was so isolated. I hadn't talked to anyone or shared, but I was feeling for months at this point.

And these feelings, these core beliefs had been building for years. So I went to the psychiatrist appointment and at that point I'd completely shut down. I remember she had me draw a pie chart of what I was feeling, and I was like, sad. I don't actually remember exactly what I drew I was so emotional that my memory of those couple of days isn't really there.

And this was also back when I was 13, five years ago. So I don't remember specifically, but I remember it was all negative, sad, hopeless emotions. And I didn't say anything the whole. She could see that I was shut down. I was isolated. I was opening up. And that's a really dangerous thing for someone that's really struggling in a really big way.

So from that point, I went ahead and spent seven or 10 days and the inpatient psychiatric unit, because I was in crisis mode with depression. I was so isolated. I was so detached from the world because of what I was experiencing. I was just trying to survive. And from that point on, there was really. A label for what I was experiencing.

These emotions, this isolation, the super low self-esteem, the low mood, the lack of energy. This was depression. And this was February of my eighth grade year. And until I went into treatment and February of my freshman year, I was in an out of the hospital. Three more times. I did everything you can imagine locally, whether it was CBT group therapy, family therapy, individual therapy, outpatient, DBT intensive outpatient, like literally everything I tried locally and nothing was changing.

I was still sad. My mood was still struggling. And after I got out of that really low point of being depressed and numbed and disassociated and detached, I started experiencing anxiety. I had anxiety when I was younger, I got anxious about things. Again, I was more sensitive. But I didn't really feel anxiety anxiety until after that depression fog lifted, it was like, I was no longer numb to everything I was feeling.

So I was feeling everything really, really, really strongly. And so that year was filled with a lot of anxiety along with depression, whether that was panic attacks or again, just like an extreme obsession with these, these belief systems fear about how I was being seen by other people what was going on in my life.

There was a lot of anxiety.

And so like I talked about that year between. My first hospital stay. And when I did intensive treatment things really compounded behaviors got introduced. And my mental health struggles were no longer just kind of internal. It really became external with the behaviors I was using in ways to try and get that validation and support.

And I remember a couple of different things that were really pivotal in that journey. The first time I was in the hospital, I remember it was really like a wraparound feeling. My mom stayed overnight with me and psychiatric observation. She came with me to the hospital.

When I went in the ambulance, she visited twice a day. We would do dinner tonight, our dinner every night together on, and I mean, any, any parent would, she was so worried about me. I was struggling so much. And as the time went on, every time I was in the hospital, whether it was for being suicidal, struggling with self-harm or just those really low points of depression and being crisis mode, Being in the hospital serve that need of feeling validated and supported and loved. It was that recognition that I was struggling in a really big way. And it was like that external, environment was affirming that yesterday you are struggling. And we see that. And I thrived on that because again, I just wanted the validation and love and support that I didn't feel like I was getting.

And so the more time I spend in the hospital, the less my parents were encouraged to kind of do that wraparound thing, drop everything, go to support me because it reinforced that behavior. And in no situation, isn't good for a young teenager in middle school, early high school to spend all of their time in a psychiatric unit.

Like that's not the goal here. Another way that I was looking for that love and support was with self harm. Something that I struggled with for a long time. I remember after I would have these crisis modes and I would engage in a behavior, they would ask me, why are you doing this?

Like, what's the reason that you are engaging in this behavior, what need is it fulfilling? And I was, it's always like, there's no need. I'm just sad. I'm overwhelmed. Like, I, I did not understand why I was doing it. and another narrative that I remember always being told was that I was going to regret this.

And I so firmly believed that I would never regret any decisions I was making as they tied to my depression and my mental health. If I got in an argument with my parents, I was like, I will never regret this. I am completely in the right. If I engaged in self-harm, I was like, I will, this is a representation of my pain and no point in my life, even when I'm 50 years old with children, will I look back on this?

Like, why did I choose to engage in this behavior? And again, I thought the rest of my life would look this way. I didn't know if I would make it past the next couple of years. So I really wasn't thinking that far into the future. But other people were, and they were asking me and I was like, no, this will be my life forever.

And this, this representation of my pain is necessary and valid and I will forever feel that way. And the more my healing evolved and has grown the more I disagree with that. And that's kind of speaks to how much our views on mental health can change and evolve with us. So I struggled with self harm a lot.

And as I look back, I know that was because it was a physical representation of my pain. It wasn't just internal. It was something that was externally like, this is the pain that I'm in. This is the physical representation. This is how much I'm struggling and people would respond and show love and care and concern.

Oh my gosh, what's happening? Like, are you okay? More so than if I was just having a really down day where I couldn't get out of bed so another way that I really was looking for the love and the connection and the validation that I was struggling and that people could see that I was struggling and they cared was with diagnoses. I had that initial depression diagnosis that prior to that point, I didn't know that what I was feeling was depression, but the more I was in and out of these different treatments, whether it was inpatient, outpatient, group therapy, family therapy, the more I thrived on getting diagnoses or recognition of what I was feeling, whether that was through behaviors or people being like, this is what you're experiencing.

It was a really concrete way to understand that I was struggling and there was a name for this. And people saw it. There was again, that, that validation, that recognition of what I was experiencing. And so same thing with like prescriptions being written for anti-depressants or different mood stabilizers.

Because again, it was like concrete validation that you're struggling. We see that and work knowledging that so suicide attempt, self harm, and really kind of leaning into these other diagnoses, whether it was struggling with berries, eating disorder behaviors really having a lot more anxiety at that point in my life, having different OCD, tendencies all of these different things were different ways that I was attempting to get validation, love, and support.

And in an ineffective way, but I was surviving and I was experiencing these emotions in a really big overwhelming way. And this is the only way that I knew how to get those needs met.

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so, like I said, I tried a lot of different treatments at home and my mood wasn't changing. I was still struggling with depression, suicidality and anxiety, as well as a bunch of different behavioral challenges, whether that was conflict with my family, self-harm suicidal ideation, like we talked about, and as I look back at my mental health journey, now, it's like abundantly clear to me why treatment didn't work, why outpatient therapy wasn't working for me. And I really bring it all back to this one interaction that I had at the beginning of intensive treatment. So in February of my freshman year, I was really backed into a corner.

I'd been hospitalized four times. I was severely suicidal. I was struggling with a bunch of different behavioral dysregulation. And I was severely depressed, severely anxious and constantly in crisis mode. And there weren't a lot of options. We tried everything locally, my mood wasn't changing. And luckily I had parents that wanted me to get better.

They weren't going to settle for me feeling this way and also causing a lot of chaos in their lives as well, with how much I was struggling. So they did a ton of research. They talked to a ton of different professionals when it became clear that I couldn't stay at home.

And they found this program called three east at McLean hospital. And it was a dialectical behavioral therapy program, which I'll talk about that in a couple of minutes, but it was an evidence-based treatment program for. Teenage girls that were struggling with depression, anxiety, and emotional dysregulation.

And what stood out to them was that it was evidence-based. There'd been dozens of studies showing the decrease in depression, decrease in anxiety, decrease in suicidal ideation of teenage girls that went through dialectical behavioral therapy treatment. And that was different from just going in and talking to a therapist and hoping that my mood would shift after this was a regimented treatment approach that was shown to improve behavioral and emotional issues.

I remember being told that I was going to go to residential. I quite obviously was not on board with this idea. I didn't want to go, but there wasn't any other option. I couldn't keep seeing my therapist at home. I again, had been struggling so much in such a big way that I just could not continue to function the way that I was.

So I packed up everything to spend what I thought would be six to eight weeks at a residential treatment program in Boston, Massachusetts, and my parents. And I flew across the country in February of my freshman year. I kind of put school on hold at that point because it wasn't something that I was able to continue doing because I was struggling in such a big way.

And we showed up to this intake appointment and we got into this room with at least eight to 10 different clinicians.

They were a psychiatrist, they were therapists, they were social workers. And they all sat in this room with me and my parents. And one of the first questions that they asked me was, do you want your parents to be here? We always give the patient the option to have their parents in the room or to do this intake appointment independently.

And I was like, I absolutely do not want them in there. And my parents had just flown across the country to get me treatment that I needed. They were dropping everything to get me the support to help me hopefully feel better.

And at this point, I so firmly believe that they were the cause of my suffering, because I only remembered it being depressed. That was all that I remembered for my entire life. And they raised me. They had a lot of impact on the environmental factors in my life. And so I was like, it must be their fault.

So I kicked them out, not one of my better moments. Thankfully, we can laugh about it now, but one of the doctors asked me his name is Dr. Blaise Aguirre, and he's actually been on the podcast. So I'll link that in the show notes. And we unpack this interview which is a really interesting full circle moment, but he asked me, he said, do you want to be here?

And I was like, no brainer. Absolutely. I do not want to be here. I've been backed into a corner. I've been told, this is my only option forward, but this isn't going to work. I have tried DBT before I've tried therapy before I've tried treatment and things. Aren't going to change. I get that other people may be, won't be depressed for the rest of their life, but I will be.

And that's just how my life. And he was, obviously, you didn't say it this way, but he was like, okay, I love that for you, but that's not how this works. Like we have seen hundreds, if not thousands of teenage girls that are exactly in your position and we've helped them, their moods have changed. They're no longer suicidal.

They're no longer depressed. I get that. You believe that, but that's also not true. And he made it very clear to me that I wasn't going to be able to just skate through this program. I wasn't going to be able to just go through the motions like I had at home.

I was only going to be able to stay at three east if I could see the wisdom and the treatment. So I actually believed that they could help me. I could only stay through east if I wanted to get better. And I had enough self compassion to want that for myself.

And I could only stay at three east. If I trusted them, I trusted their competency. I trusted their experience and I put enough emotional trust in them to help support me and everything changed from there. Up until that point in my life, I'd never cultivated enough.

Self-compassion to want to live a life worth living. I've never fully trusted people to help me get better from a mental health standpoint, I'd never believed that they could help me. And I never saw the wisdom. I never logically believed that a treatment would work for me to no longer feel depressed and suicidal and overwhelmed and suffer.

Without a clear like end point of that stuff. So I want to give you a quick little picture of what things look like when I started McLean, because I've kind of talked about these like very emote, various emotions that I was feeling, but this was really like my low point. This was the rock bottom. This was me backed into a corner.

I blamed my parents for every single thing I was feeling. There was no accountability. There was no kind of belief that I have gotten into this point and I can get myself out of it. I had extremely low self-esteem self hatred. I, again, didn't think that I deserved love or care or relationships or support or any of these things.

And I was so, so, so hopeless and firmly believed that my life would never change. Behaviorally I was really struggling whether it was with suicidal ideation, panic attacks different OCD tendencies. My eating was all over the place. I could not sleep through the night. And I avoided sleeping at all costs.

I was constantly arguing with my parents. I was isolated from all my relationships. So things were a mess. This was my rock bottom I, every single day, if I put it on a scale of like one to 10, as far as my mood and being depressed every single day was a 10 out of 10. Every single day was a 10 out of 10 for wanting to end my life.

And every single day was like an eight or a nine out of 10 for the worst anxiety that I'd ever felt. So now we enter DBT or dialectical behavioral therapy. and because DBT was really what was such a game changer for me. And it's kind of like a niche area of the treatment world.

It's kind of difficult for me to not explain a little bit of what that is before we dive into the rest of my treatments. So DBT stands for dialectical behavioral therapy. It is an evidence-based treatment that was developed by Marsha Linehan for adults that were severely struggling with borderline personality disorder and suicidal ideation and suicide attempts.

And so if you're familiar with borderline, it is a personality disorder. That's characterized by a lot of impulsivity, super low mood really struggling relationships extreme depression And a whole lot of emotions, feelings and behaviors that can also show up in things like depression and anxiety in teens that are really struggling.

And so that's why DBT has now been used to treat other disorders, but it originally started as a treatment for BPD and it was extremely effective. It was one of the first treatments that actually worked to help patients that were struggling with BPD because prior to this innovation in the treatment field therapists were really hesitant to take on BPD patients.

Because again, they were extremely suicidal, they were extremely emotional. They didn't want to change. And so DBT really changed everything in that perspective. And what DBT is, is it's an evidence-based treatment protocol

and there's a couple of different areas of the treatment. There is the skills education, which is what you see me share every week on the podcast and share on social media and what I really do feel as applicable to everyone. And so that is literally like hundreds of skills that teach you how to live your life effectively.

And if you're living your life in a way that your mental health isn't like constantly struggling, chances are, you're doing a lot of these things, but like, like I talked about, the more I struggled, the further I departed from this effective way of functioning and my relationships and my emotions in my activities of daily living.

So what DBT does is it brings you back to this effective way of functioning and a really clear step-by-step outlined way, which is super helpful for patients that are really struggling to be effective in their relationships and being mindful and regulating their emotions and tolerating distress.

And those are all the different modules of the skills that. The next part of DBT is the therapy part. You are working with a therapist, and if you're an adolescent, a lot of the times you're doing family therapy as well. So you are working on crisis behaviors. You're working on big emotions. You're working on things that come up throughout the week.

You're unpacking belief systems and you're working to unpack what your life worth living looks like and working towards that point. So therapy is another part of it. And when you're doing intensive DBT, like I did at McLean, you are also doing a lot of group therapy and working with other teams and peers If you are doing outpatient, DBTA, there's another thing called skills coaching.

So when you're having these crisis moments, when you're feeling overwhelmed, you can call your therapist and get coaching through the moment on how you can use your skills, how you can navigate this situation effectively. And the last component of DBT is that your therapist is working on a board. Your therapist is working on a team of other DBT clinicians, constantly in a collaborative approach to make sure that you are getting treatment.

That is evidence-based. It's what the study show to be effective. In DBT also has the core belief that therapists need support too. And so that's really built to help your therapists get the support that they need to give you the best treatment possible. So without diving into too much crazy detail.

My time at McClain was like tons of group therapy, tons of individual therapy. I remember I was doing individual therapy five days a week, which is a lot. And there was a lot of emphasis on changing my habits and my activities of daily living. So sleeping through the night, targeting that insomnia and napping through the day when I just wanted to isolate I started to build foundations with my relationships with my parents and be vulnerable with my peers at the program.

We targeted the different behavioral aspects of depression, anxiety, OCD, my diet, all of these things to get back to a point of like baseline normal functioning to so that I wasn't further making my life forth. So like if I wasn't sleeping through the night, if I wasn't eating and if I was causing conflict with my parents, my mental health was just constantly getting worse.

But if I could sleep through the night and eat a balanced diet and have activities to go through during the day, that kept me motivated. My mental health was generally like on an upward trajectory. And I could also target these core belief systems and other things. So that was kind of what, my time at three east look like. And I ended up being there for 14 weeks. Again, I went there thinking I would be there for four to six weeks and I was there for 14. So again, I started. Three east being severely suicidal, severely depressed relationship dysfunction, all of that kind of stuff. And 14 weeks later for the first time that I could remember in years, I was waking up in the morning and not feeling suicidal.

And I was not feeling depressed 24 hours a day, and I could sleep through the night. And I knew how to understand my anxiety in a way where it wasn't controlling my entire life. And I started to build a relationship with my parents and I was starting to shift these core belief systems and things were really changing.

And it had literally only been 14 weeks. I think anyone that's circled with their mental health knows like this is a lifelong journey. 14 weeks is not enough time to just go back to your original home, your original place in the gap. My life is self forever and that meant that there was going to be a next step in my treatment journey.

And so this is again, something that's kind of unique to adolescent tree men versus when you're an adult. I think if I was an adult, at that point, I could have gone home and maybe shifted my relationships or my job or school, whatever it was that I was doing.

But if I were to go home, I would have gone exactly back into the environment that before was so stressful for me.

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So we started to explore the idea of a therapeutic boarding school. And this was something that was really discouraging to me because I'd done all of this profound work. I had decided to take suicide off the table.

I had pulled myself out of the worst depression that I'd ever been in. I had coped through my anxiety. I'd built these relationships. I had done more work than I'd ever done in my entire life before and myself. And it showed And I just kept hearing the message that, that wasn't good enough. I had to get more treatment.

I had to do more work and that I hadn't done enough. And obviously that wasn't the case. They wanted to give me the best chance of true recovery in a long-term way. So that I wouldn't be back in treatment and inpatient outpatient a year from them. So I ended up spending 14 months at a therapeutic boarding school. And while I continued on the general trajectory of. Maintaining my emotional stability that I created and building relationships and healing my relationship with my parents. I look back on that time as not one of the best points in my life, because a lot of the practices at that program weren't necessarily ethical.

There weren't evidence-based treatment protocols being implemented. The girls, there were extremely isolated from their families. There was a lot of things that were not as effective and amazing as three east and so I just want to emphasize here that while there is treatment and it's amazing, and it can change life and save lives like threes did for me. Not all treatment is evidence-based not all treatment is regulated and there's a lot of room for growth there as an industry.

And I'll link episodes below talking about that in more depth. But that was another part of my treatment was maintaining that progress during my time at boarding school, before I moved home right before my junior year. And at the tail end of my time and treatment, I started she persisted. I remember right before that intake appointment that I mentioned, my dad said to me, he was like, Sadie, think about how profound this is going to be, that you're going through all of this mental health journey, work growth.

And so many teen girls struggle with depression. Like this could be so inspiring. And I, again, I hated my parents. I blame them for all my problems. He was like, you should start a podcast. And I was like, no, I will not be starting a podcast. That's stupid. I remember we were in the intake appointment and he literally asked one of the doctors.

He was like, can she have a recording device here for a podcast? Sorry. That is a huge HIPPA violation. Of course, she cannot have a recording device. Like what are you talking about? So I wrote that idea off, but a year and a half later, I realized that what people told me was true. I realized that I could live my life worth living and that I was no longer depressed and that I was happy and I was loving my life, which was something I never thought would be true.

There was this complete 180. So I really was like, if I, this person who is so strongly believed that I was forever destined to be depressed, can live their life worth living than anyone can. And I really wanted to share my story. And I really did feel like there was a huge lack of teens that were sharing that narrative of like, it can get better, you can do it and you can take ownership of your mental health.

So many adults told me it was possible, but teens did it. And so there was that huge lack and it was kind of hard to resonate and believe that when like a doctor tells you like, oh, like you can get better. You can feel better. You can change your life. I was like, yeah, I get like, you're an adult. You have so much autonomy, but like, I'm a teen like this, I don't relate.

I don't resonate. So I feel that was a huge gap. And so when I was like, how can I share my story? I felt like there weren't a lot of teen podcasters. And I went back to this idea that my dad had initially planted. And I started she persisted and I began. Begging my friends to record with me and share their stories and talking about what we've been through and all the growth we'd had.

And talking about how you truly can take ownership of your mental health as a teen and how we did that. And I remember doing like probably like 10 episodes or just kind of a lot where I just talked about my mental health journey and it was, I was like, this is too much. There's a lot. I can't just keep talking about myself forever.

And so I started to do interviews with other individuals. I started to explore different areas of mental health, whether it was depression or anxiety and meditation, OCD different treatment approaches and talking to experts and fellow teenagers and individuals who had gone through huge periods of self-growth and healing to share those stories with teens who were looking for the motivation, inspiration, that things can get better.

So here we are. Two and a half, almost three years later with 80 episodes. And a whole lot of self-growth. And so that's kind of how she persisted came to be. It was all born from my mental health struggle. And I remember when I started, she persisted when I. Literally, I'm not making this up two listeners a month. I was like, if one person can feel seen and heard and validated, it's all worth it. Every single thing that I went through with my depression and my anxiety and my suicidal ideation and just the extremely dysfunction and suffering that I experienced is worth it.

If someone else can not feel the pain that I went through. And she persisted was a way to do that as a 15 year old. Maybe I was 16 when I started the podcast. Yeah. As a 16 year old, obviously. Be a therapist to other people at that point in my life, I couldn't offer them professional support, but I could share my story and hope that it resonated and provided that validation that I so desperately wanted, needed and was looking for when I was really struggling.

So today I'm constantly working on my mental health. Mental health is just like your physical health. You have to continue to work on it and invest in it to expect it to be maintained and okay. I still go to therapy and I love therapy. I'm a huge proponent of it. And it's so funny because my relationship to therapy.

Changed drastically from my, when I started treatment at the beginning, it was like this lifeline again, I talked about doing five days of individual therapy a week on top of like at least 15 group therapy sessions a week. And now it's like once a week and I'm talking about random things. Like, I want to start walking more days a week.

How can I make sure that I'm getting more steps in or like I'm really stressed about this test coming up? What are some better ways that I can study or like, oh my gosh, I saw the funniest tech talk. You have to watch this. Like my relationship with it has changed so much. And now it's a point for me to continue to explore things that come up.

It's a way for me to maintain my mental health prevent struggling in the future. But again, I'm no longer like continuing to like pull myself out of that rock. But I wanted to share a couple of things about depression that I heard this week in my psychology class, I think really relate to the story and my outlook, my core beliefs that I talked about.

And these are kind of like insights that I now have that I didn't have when I was struggling. But if you're struggling, if you relate to this, I think there'll be really helpful to hear. So the first thing is that depression, a lot of the time when we look at it from a psychology perspective, when we look at the research, when we look at how people talk about their experiences, at least part of the time, it's about a wrongly pessimistic outlook. So like I talked about how I was constantly looking for circumstantial evidence that I wasn't good enough that I was unlovable that my life sucked. And I found that because that was all I was looking for that pessimistic outlook added to my mood.

And so in general, when we can get out of that pessimistic outlook, that's not necessarily accurate things usually are or will be better than they seem right now in this moment. So if you're struggling, if you're at that extreme low, if you're unconsciously looking for all of that circumstantial evidence that supports what you're feeling, I promise you that things are better or they will be better than they seem right now in this current mode.

The next thing is that when we look at emotions across your lifespan, when we look at the research that's been done there, how people rate their, their joy, their feelings of like living their life worth living, people are happier across time, just in general. Their happiness tends to trend upward over time.

So if you're at like your extreme low right now, if you're like, things cannot get worse. I hate my life. I hate what I'm feeling. I'm feeling overwhelmed. This stocks in general, the trend is that that will change. Things will get better. They have to. And one mantra that I really love that I actually heard from recording with Dr.

Gary, we talked about, I just love that episode so much is that life is impermanent and that impermanence will be on your side. So even though you might be an extreme emotional low right now, you might be suffering. No emotion, nothing in life is constant. That extreme feeling of suffering cannot persist forever.

It has to shift. It has to change. Something has to give, and that will be on your side, the pain, the suffering it'll lift. It will change. It will evolve and it can't stay as constant and as overwhelming as it is right now. And the last thing is that the future is really difficult to predict, obviously, but from like a personal perspective when we look at the research on how people forecast their life and how things will look like five years from now, People really overestimate the impact of what's happening now on their future happiness.

We think that everything that's going on right now in the current moment, whether it's a test, a relationship and argument is like drastically going to impact our happiness and our lives five years from now. Whereas like five years from now, if you're like, what happened about that test that you took freshman year of high school, you'd be like, what?

Like is not even relevant remotely to my life. But right now it really does feel like everything that's going on has an impact and emphasis on your joy and your wellbeing. Not only right now, but in general, in your future life. And so it's important to remember that we're really bad at predicting how much things will impact our lives and our wellbeing, especially in the future.

So if you're feeling really overwhelmed, if you're feeling like you're, you're just at rock bottom and things suck and they will suck forever, we're not good at predicting that future. And that, that was true for me. I believed that I would be forever depressed for the rest of my life. And here I am having not been depressed in years.

So we're just bad at predicting our futures. And that really is in your face. If you're struggling. So I wanted to really quickly dive into a couple of habits that were game changers in my mental health journey that you can implement without going to intensive treatment or all of these different things.

And then I'm going to answer some of your questions that you asked on Instagram about my mental health journey. So the first thing is sleep. Sleep is my number one, mental health tip. Sleep has a huge impact on our mood, on our emotional vulnerability. If you are not getting enough sleep or you're not getting good enough sleep, your emotions will suffer. So investing in your sleep, making sure that you're getting enough, no matter where you're at in your mental health journey will at least somewhat improve your baseline of functioning.

Medication was another really big part of my journey and something that I still continue to unpack as I explore mental health and do more research. But I just so strongly believed in the impact of therapy and environmental factors on depression. So if you haven't read loss connections by Johann Hari, this is a really illuminating and unique approach about how environment impacts mood and how the research on medication and like having like a biological cause of depression like in your brain is, is really changing.

So I really recommend you read that if you're kind of exploring medication as an option, Relationships again, when I was struggling, all I was doing was trying to feel loved, connected, supported, and validated. So having relationships in your life that allow you to feel that way is a game changer for your mental health having a passion project and something that brings you joy, that you can invest in.

That's motivating to you is huge. And that today for me is like the podcast at school. It's all of these different things that I love doing, and they have a huge, positive impact on my mental health. Another thing is accumulating positives. There's this amazing DBT scale where you plan moments of joy throughout your day, so that when you have those low moments in mood, you can't get into that head space of like everything sucks.

The world is terrible because you've accumulated all these different moments of joy. So your baseline is increased. And that's something that I implement on a daily, weekly, monthly basis. And something that is so easy to do is to like, okay, I'm going to drink my favorite cup of coffee tomorrow, and I'm going to sit and enjoy it, or I'm going to watch my favorite TV show tomorrow night, and it's going to be great.

Or I'm going to go have coffee with a friend. And I know that I'll have a great time. Plan those moments, build your life worth living for yourself. And that's something that is easy to do. It's fun. And it's the best. The last two things I'm going to say. One is just giving myself grace, we all have tough moments.

We all have bad days. Our mental health is constantly changing and fluctuating and we can't always be perfect or on an upward trend. And so I give myself a lot of understanding and compassion when I'm struggling or when things don't go my way or when it feels like I don't understand what's going on.

And that's something that I wish I had done when I was really struggling giving myself grace and being like, you know what? Like you're, you're struggling a lot right now. Everything is going on. I'm in a really crazy, huge, big way. And does so it's okay to feel overwhelmed and it's okay to not know how to proceed and things will change.

So really self-compassion giving yourself understanding. And another huge part of my mental health in the past couple of years has been the podcast because every single week I'm sitting for these interviews, these conversations, these hour of self reflection And that has just caused me to constantly push my understandings of my own mental health and mental health in general of things like depression and anxiety.

And I think that has really been a huge factor in maintaining my mental health.

This week's episode is sponsored by teen counseling. As you've heard, therapy was such a pivotal part of my journey. It was what changed my life. It was what saved my life, and it is something that I continue to implement on a weekly basis to maintain my mental health progress. I can't speak highly enough of it.

I think that some version of therapy can be beneficial to anyone no matter what you're going through, because it can be so tailored to your needs and what you need support on. So teen counseling is an online therapy program with over 14,000 licensed therapists and their network. They offer support on things like depression, anxiety, relationships, trauma, and more through text talk and video counseling and more through text talk and video counseling.

So if you've never tried therapy before, you're a little bit nervous, but you want support, sign up for phone coaching, you can get support via text from a licensed counselor, which is just an amazing resource to have in your toolbox.

So, what you're going to do is you're going to have the teen counseling.com as she persisted. You're going to fill out a survey about what you're hoping to work on in therapy and what you'd like support on.

Based on that information, teen counseling will help match you with a therapist that meets your needs, and they'll send a simple, super discreet email to your parents to get consent for treatment. I tried the email, I send it to myself. Don't worry. They don't disclose anything about what you want to work on, or what you're struggling with.

They just say Sadie or whatever your name is, is hoping to meet with a counselor from teen counseling. Please learn more here in give consent for treatment. From there, your parent gives permission. You set up payment and you are matched with a counselor that meets your needs. So to start working with a therapist today, you can head to teencounseling.com/shepersisted again, that is teencounseling.com/shepersisted.

So you guys ask me questions on Instagram and we are going to answer them to make sure that this episode is helpful to you.

The first question is, have you ever relapsed into your depression or once you got rid of it, was it gone for good? Absolutely. I think that the more I understand it on PAC mental health and depression, the more I understand depression is an emotion, it's a mood. It's something that we all experience at various times to varying degrees.

I have days where I'm feeling more depressed, where I'm lacking motivation. I have months where I look back and I'm like, wow. Like I really wasn't at my best there, but because I've done this deep work of rewiring, my core belief systems of building a life worth living, I don't get back to that deep hole of struggling.

I don't get back to that rock bottom. So when I have moments of low mood, when I have moments where I'm feeling overwhelmed, instead of becoming extremely suicidal or ending up in the hostile. I have ways that I can go through it. I have relationships in place. I have habits that helped me improve my mental health so that I can work through the emotions without letting them dictate my entire life.

Is depression hereditary. We've talked about this at the beginning bio-psycho-social approach while you can genetically be more susceptible, you can experience your emotions more strongly. There is no gene. That's just will make you depressed. There's no baby, that's born. And you're like, yep. They're going to grow up and be depressed.

Like that's just not how it works. There's an extreme amount of. Of things in your environment that can impact depression and you have a lot of power to be able to influence how you experience the world and your mood. So while maybe you might feel your emotions more strongly like I do. So it might be easier to get into that depression head space there you're not guaranteed to be depressed or struggle severely you have a lot of steps that you can take to improve your mental health and not feel that way.

If it's something that isn't within your life worth living Have you ever felt shamed speaking to people you are close to about your mental health? Yes. Even as we started this podcast recording, I was like, this is weird. This is kind of awkward. Like this feels uncomfortable. This is a lot of vulnerability. Mental health struggles, depression, anxiety, core beliefs.

They're all things that we hold really close to our hearts. It's all things that put it at re put us at risk for rejection or not feeling seen validated, supported all of these things. So of course there have been moments where sharing that and being vulnerable is fearful. It gives you anxiety. You have the power to surround yourself with people that help you feel uplifted and supported and validated and not shamed for your mental health struggles, they can hold you accountable without blaming you or judging you. So while you might feel anxious about being vulnerable and sharing things, I think surrounding yourself with people that don't increase, that shame is really powerful and constantly pushing yourself to be more vulnerable.

Doing exposure therapy to those emotions is, is huge. And decreasing those feelings of shame and embarrassment with what you've experienced over time. Where did you start to notice your own mental health? I realized around seven. I remember when I was really younger in my relationship with my siblings, especially how I showed up, how I felt about myself.

Like my self esteem. Like if we would get an argument, I'd be like, am I a bad person for like, saying these things are for us not having a good relationship on, and then, because again, I had these core beliefs, I just remember generally not feeling super great. But the first time that I really noticed my mental health through a perspective of like diagnoses and treatment was eighth grade, freshman year when I got that depression diagnosis.

And then looking back, I was like, my mental health was just bad before that point. My core belief system struggled, I wasn't working to improve my relationships, my habits of daily living. So there wasn't like a keen awareness of it or an awareness that things might be an effective. But they were definitely at play and they were definitely there.

Do you believe that we can turn around this rise in depression and anxiety? Absolutely. We can only change ourselves. We can't change others, beliefs, opinions, actions. So I think it's really sharing our own stories and the hope that we can inspire others to take ownership of their own mental health.

So I think if we create enough of an open narrative about how empowering and amazing mental health work can be, and we share how possible it is to build your life worth living and make mental health resources more accessible. We can absolutely change these depression and anxiety rates, but it's something that everyone has to make that decision for themselves.

They have to be intrinsically motivated to want to change and believe that they can change. Otherwise. Again, just like me, you go through the motions and you will not notice a long lasting.

How do you think your own journey relates to the collective experience? I think that a lot of my nitty-gritty, whether it was like the self-harm and suicidal ideation, the time and inpatient, the intensive treatment, that's where it's not as relatable. The emotions of feeling unloved feeling invalidated feeling hopeless feeling like things would never change.

That's what everyone gets everywhere has been in that Headspace at some point in their life. And that's what everyone can relate to. So it's the emotions. It's, it's the, it's the feelings of anxiety. It's the feelings of fear. It's the, it's the it's the shame around feeling, not good enough. It's the self-esteem issues.

That is what is relatable. And that's how you can get that validation and support that I so badly needed. So I think the, the nitty gritty is what isolates us and separates us with the emotions is what really brings us to. Did you have a bottom point or a rock bottom? And how did you overcome? Yes, freshman year, eighth grade, we talked about going to McLean.

That was my rock bottom, severely suicidal, severely struggling with depression self harm and effective relationships, literally so many different things that were just not in a great point. I was backed into a corner. I was lucky to have people around me that wanted me to get better and encourage me to get better and helped me have the professional resources to get better.

And that's how I overcame. I had a huge wraparound of clinicians, parents, friends, family members, that were willing to support me in my journey and help me get those professional evidence-based resources to get out of that depression. And I cultivated the compassion to want to get better and to want to build a life worth living for myself and seeing the wisdom and, and treatment and believing that it was possible for me to get better.

How could people support you best in your journey before professional support? And after there are so many different ways that you can support someone, but again, it all comes back to validation being there for someone and just saying like, Hey, I see you. I hear you. I know you're struggling. And I get that.

And maybe I haven't been in your exact position, but I just want to know, like, I see you, I see your experience and I'm here for you is so powerful. I think also being an escape for someone is something that's really powerful being someone that they can go to, to a laugh and have a good time and feel supported.

And, and be part of that life worth living is an amazing way to support someone both before treatment and after. So whether that's inviting them out to coffee and having a good time or being like, I really like want to watch a fun movie with you having your relationship be an outlet that's really supportive, joyful, amazing to be around what stereotype.

What was the stereotype you had going into treatment and healing? That was totally untrue that it was impossible. I did not believe that I could get better. I thought that my depression was something that was going to last for the rest of my life. I thought that Truman wasn't going to work. That was completely untrue, Truman worked.

I'm no longer depressed. I'm no longer suicidal. And so all of those beliefs were not true. And it was just a, and it just took time to see that when was the moment you woke up and finally felt closer to yourself and transformed. It was when I was at three east. And I remember, I don't remember exactly what day it was, but I remember waking up and opening my eyes in the morning and being like, wait a minute, this feels weird.

I'm not depressed right now. And that was a result of having sleep in place of building my relationships of unpacking my core belief systems and having self compassion and learning how to cope through emotions without them completely like ruling my every move. So that was that moment. And then the other one was when I just took suicide off the table as an option, I remember I was in therapy and my therapist was like, so you're struggling a lot with suicidal ideation, like walk me through this.

And I was like, well, it's always on the back burner. Like if all else fails, like that's an option. And she was like, yep, that's gonna need to no longer be an option. She was like, I can't make this decision for you, but you're going to have to get to the point where that back-burner doesn't exist. So I remember I just made the decision.

I was like, from this point forward in my life, the backburner is not there. No matter what I experienced, no matter how overwhelmed I feel, no matter how isolated I am, that is not an option I will pursue. And that was another moment of transformation that really changed the trajectory of my. What role, if any, has creativity or being creative person played in your journey past and projects are so powerful and improving your mental health, they energize you.

They give you motivation. They make you feel pride and joyful, and it, it gives you something to do. Depression is really like, again, tied to this feeling of lack of motivation. I feel like passion projects and creativity can really help supplement that it's not everything, but the podcast and social media management and graphic design, all of these things that I've kind of dove into in the past couple of years, I really do think have helped me continue to maintain and improve my mental health and feel energized and motivated and creative and just good.

And in my life with. What was the biggest or smallest shift that helped in your healing? So, so, so many different things. We've covered a lot of them in this episode sleeping a non-negotiable asking for help when you need it accepting the help of others. Taking suicide off the table as an option.

Changing your core belief systems. I remember a big thing for me. Especially during like that year, after that first initial change, I would notice that I would have interactions where I would revert to those belief systems. Like I would say hi to someone I'd say they don't actually want to say hi to me.

Like I'm not deserving a relationship. So this must just, they must feel obligated to say hi to me. And I would internally do that. Switch a big, Nope, I'm deserving of love. I am deserving of care. I'm deserving of healthy relationships and that's just a fact. And that's something I still do continuing to shift those belief systems is a small shift, but it's something that you continue to do over time and it has a profound impact.

Last question is what is the biggest impact on your healing and growth? I think. The self-empowerment again, we go back to this idea of my mental health changed when I had enough self compassion to want to get better.

And I believe that I could get better before that I did all the same treatments. I learned DBT scales. I tried to invest in my relationships. I tried to improve my esteem and nothing worked. It was only once I wanted to get better. I believed I could get better. And I had enough self-compassion to want to get better.

That things actually changed. And so that, that was the biggest thing was the, self-empowerment the doing it for myself. And not for anyone else that was when my mental health changed and I no longer felt depressed. I no longer felt suicidal. I was able to work through my emotions. And it's redundant.

You've heard it so many times in this episode, but I, I just think that was the biggest thing in my journey. And I think that a lot of people can relate to that. If you've been through a healing, mental health journey, So it's all questions I'm going to answer. It's been a long episode and a whole lot of information thrown at you, but I hope this was helpful and validating and it resonated.

And that was a little bit about me and my mental health journey and why I started she persisted. So as always, if you enjoyed this episode, be sure to share it with a friend or family member. If you share it on social media, make sure to tag me and I'll repost and give you a little shout out.

And I just want to Ms. By reminding you that you're not alone, someone in the world has been where you are and will know when a hundred percent gets what your mind is going through right now, what emotions you're feeling, what thoughts you're having, what behaviors you're engaging in. People can relate.

They can understand they can resonate and they can support you. Ask for help get the support and resources that you are so deserving of and have enough self-compassion cultivate that self-compassion to want to get better because you are deserving of a life worth living. Regardless, like that's just a statement.

You are deserving of a life worth living a life that you love and enjoy and feel fulfilled in regardless of who you are, what you've gone through. That's just a fact. So want that for yourself? Start to build that for yourself so yeah, I hope you enjoyed this episode and I'll see you next Monday.

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