Mental May

Elisa A. Escalante/ LCSW/ 05-15-2025

Every year I promise myself that I will take the month of May more seriously. As it is mental health awareness month. But life get’s the best of me. I was racking my brain on how I could possibly write a blog about mental health for May, as it is such a broad topic and a blog is so short. But it dawned on me. People should be aware of why people actually go get mental health treatment in the first place. I still read many opinions/ impressions/ judgements online about therapy, and why it is or is not ‘useful’. Many people still do not understand how beneficial mental health treatment is. So I want to provide some brief summaries on the many different reasons human beings might seek mental health counseling and why it could be beneficial in the long run.

Mental health conditions: a- Psychosis; Some people meet the criteria for a psychotic d/o which would include hallucinations: seeing/ hearing/ feeling things that are not actively present. Also present would be delusions; known as fixed ‘false beliefs’ that cannot be proven and are not a part of anyone else’s ‘reality’. (Schizophrenia would be a prime example, and this diagnosis has multiple sub categories and can show up differently in people) Sometimes psychosis requires inpatient hospitalizations and medications. Some people can manage psychosis with medications and outpatient therapy alone. b-non psychotic; The reason I want to differentiate, is because the old school mentality is that ‘mental health is for crazy people’. When people say the term ‘crazy’, they may be referring to psychosis. There’s also many people that get mental health treatment for non psychotic disorders. Sometimes these mental illnesses are debilitating. Sometimes people can be high functioning with them, depending on the severity and circumstances. This includes depression, anxiety/ panic disorders, OCD, Neuro developmental disorders (such as ADHD), PTSD (and/ or personality and attachment disorders which are known as sub disorders due to complex childhood related PTSD), sexual disorders, dissociative disorders (Dissociative identity disorder, formerly known as Multiple personality disorder, would be included in this realm), or mood disorders (such as Bipolar d/o; depressive and manic features).

Relationship stress– Marital, family, coworker, and friendship stressors are a significant portion of outpatient therapy. This comes up almost every single day I am at work. As certain as we are that there will be oxygen to breathe each day, there will also be a person in our lives that has the potential to stress us out, or even traumatize us! This includes relationships that are plagued with trauma bonds, codependency, lack of compatibility, abusive people, passive aggressive or aggressive work relationships, rushed marriages, complex family dynamics, blended families, parental stressors, infidelity & betrayal trauma, families plagued with mental health concerns, substance abuse disorders and/ or multi generational traumas.

Work stress (burnout)- Humans are plagued with heavy pressure to work, provide, consume, reproduce and to continue this cycle. We are pushed to generate things like money, wealth, progress, projects and more. Some people align work with their entire life purpose and identity. Many will admit work can be escapism from an ill mind. (The illness is then translated into the behaviors). Long work hours and/ or heavy emotional, mental or physical labor will erode the mind and body. But people may keep working well past burnout; especially if their livelihood depends on it.

Financial stressors– Despite the hard work being generated and money being made, our bills and debts will keep us in a cycle. Working hard and paying hard is what society has demanded we do. I never ask my patients about specific numbers but I do encourage them to open up about their money related stress if it is on their mind and exacerbating their mental health symptoms and relationships; it often does. And, not everyone get’s relief. Not everyone has generational wealth. Some people were not taught anything about money besides how to spend it fast. Some people do not make enough to sustain themselves. Some people make ‘just enough’ to barely survive, but may not qualify for social welfare resources. It’s brutal out here.

Grief- Loss is an inevitable part of life. “It’s normal”, and yet so excruciatingly painful. It is not talked about enough. Society is not patient enough for those that are grieving. We may also grieve a multitude of things such as: job loss, loss due to death of family members, friends, pets or lovers, loss of people due to break ups or moving, loss of abilities due to illness or natural aging, loss of purpose, loss of identity and more. I would dare say that there are not enough bereavement days for the grievances that we as humans must endure.

Caregiver burnout- There is also the brutally slow and painful type of loss. Such as caregiving for a loved one as they are painfully dying. This can be weeks, months or years. Caregiver burnout/ depression/ grief is significant and complex. The people that take on these roles I would describe as ‘guardian angels’ that walk the Earth. It’s one of the hardest things someone can do and yet there are people that step up and do it. Out of love and out of fear. The people who have fallen ill will suffer, their caregivers suffer just as much, sometimes even more. They often forget about their own self care as they learn to balance their new life. Many work, balance finances, caregiving and may not have time for much else. They may also be met with a lot of resistance from their loved one; someone who is grieving as they are now limited in physical/ mental capacity. They may be lashing out due to the shame of requiring help and feeling like a burden to others.

Medical conditions that exacerbate mental health– Because I am now a behavioral health consultant for a Primary care clinic, I now have the added responsibility of being well versed in various different medical conditions and how they impact people’s mental health on a daily basis. I have learned a lot more about chronic medical and pain conditions such as: autoimmune disorders, diabetes, chronic musculoskeletal injuries, nerve pain, seizure disorders, heart/ lung/ liver conditions, sleep disorders (both components of medical and mental health s/x perpetuate sleep problems), gastrointestinal conditions etc. It’s important to see people through a holistic lens; we are our biology, our psychology and our social environments. And yes, every medical and pain condition can/ and often will exacerbate mental health symptoms.

Post partum states– Pregnancy, labor, delivery and/ or C sections. Then the post partum state itself; hormonal factors combined with busy parenting demands, recovery pain, fatigue, & flair ups of depression, anxiety, anger and sometimes acute traumas. Social environments can make or break this process as well; does the new Mom have a supportive spouse and family around her, or a toxic non helpful one? In primary care I receive many post partum referrals. The last three years have been a learning experience for me as I have never been pregnant, and I am childfree. This is a very fragile and vulnerable process and it is met with so much strength and resiliency. I am very impressed and horrified all at the same time. Mom’s are incredible beings and they deserve post partum care. There is so much that can go right or ‘wrong’ every step of the way.

Addictions and eating disorders– Addictions, obsessions, compulsions, regret, shame and physical/ mental health consequences. Humans are susceptible to addictions and eating disorders due to biopsychosocial factors as well. These are disorders that are heavily shamed, judged and misunderstood. Since they are also secondary conditions that have various underlying mental disorders and social environment triggers, they must be handled with care. Also known as a dual diagnosis; a mental health condition combined with a substance abuse disorder. People deserve praise for showing up to get treated for these conditions, as they are severely judged in the public eye. Due to this the addictive or compulsive behaviors are often done in secrecy. It’s important to note that they are also the deadliest mental conditions known to humanity; opioid overdoses and eating disorders lead to the highest death rates amongst mental health patients.

Transitional/ adjustment stressors– People grow through life. People change and go through changes. We deal with different stages of development in our upbringing, we go through puberty, we move, we switch jobs, we end relationships and form new ones. We create families, we blend families. We as individuals might change; identity, purpose, ideas, preferences, needs, personality traits and more. We will experience stress and growing pains throughout life even if we do not suffer from a mental health disorder. The human experience involves suffering. Change can be uncomfortable. In my line of work, I’ve also helped people navigate very rare transitions such as coming home from war zones, getting out of the military, marrying into the military, being far from family all of the time because of the military. People learning very rare jobs that most people do not understand… in the military. Spouse’s that have the challenge of more single parenting responsibilities, because of the military missions.

Therapist responsibilities: Mental health clinicians are responsible for performing psychosocial assessments on clients. We assess, we diagnose, and we build treatment plans that are tailored to the patients needs and mental health conditions. The treatment plans are often required to be ‘evidenced based’. Meaning there was already a board approved research study conducted that had proven that the interventions do provide at least some short term relief on mental health patients. We also need to be flexible, adaptable and roll with resistance. Patients might change their minds. Or their life circumstances could change in an instant. No where in this process do we use our opinions and judgements. Nor do we vomit out the mouth with poor advice. (Ideally) Rarely do we ever talk about ourselves (unless it is helpful & relevant to the patients needs/ situation) Our education, our ethics, and our empathy must combine to create a beautiful blend of therapy. There is nothing else like this experience for the patient. There is no other profession like this profession. Friends, family, life coaches and online influencers may try to emulate it. They cannot. Mental health therapy is an art and a science.