Wellness at Berkeley Module 12: Mental Health


(light instrumental music) – There’s no two ways about it. Your mental health is critical
for your success at Cal. I’m Rodolfo Mendoza-Denton, a
psychology professor at Cal. And your co-host, along
with Dree Kavoussi, fourth-year undergraduate
student, and ASUC senator. I’m joined today to talk about
the topic of mental health by three distinguished guests. First, Madison Gordon, ASUC senator. Second, Aaron Cohen,
senior staff psychologist in the Counseling and
Psychological Services unit in the University of California Berkeley. And Stephen Hinshaw, a professor in the Department of
Psychology, and Vice Chair of Psychology and the
Department of Psychiatry, in the University of
California San Francisco. To each of you, thank you for being here, and thank you for sharing
your wisdom with us. Let’s get started. – So right off the bat, how did ya’ll get
interested in mental health? Steve, do you wanna lead us in? – I got interested in mental
health, it’s a very long story, but the short version
is, as a kid, growing up in the Midwest, my dad would
disappear from time to time. And what I didn’t know
then is, the family was under doctor’s orders
to say nothing about it. I didn’t know that he was disappearing into mental hospitals. When he finally came out
of the closet with this when I was 17 and had gone off to college, I realized that my life’s calling was to work on mental health,
and work with children, and try to solve some of these problems from a research and a
clinical perspective. So I was hooked ever since. – And Steve I happen to know that you’ve written a book about this, if not several. – Yes, I’ve tried to blend
my scientific interest in children and family mental health with narrative and disclosure. I wrote a book a dozen years ago called The Years of Silence are Past, dealing with the silence
of my family growing up. And other books about
narrative mental health, as well as the science. – We’ll get into those, thank you Steve. – Thank you, Madison, what about you? – Yeah, very similarly, stems from personal and family history. I suffered with my own mental health for as long as I can remember. And it wasn’t until I
graduated from high school, took some time off and
then started college that I was able to really
reflect on where I was. Went to see a counselor,
and realized that I had been suffering from clinical depression and anxiety for many years in my life. And since, have gone through
a really great journey, visiting therapists and psychiatrists, and realizing that I’m not
the only one here at Berkeley, I’m not the only student going through it. And yeah, that’s where I got started. – Thank you, and Aaron? – Well it’s amazing how the
family and the personal, I think many mental health
providers have been touched, and had some personal experience, and that was how it was for me. I struggled as a youngster,
and really looked up to the psychologist that I saw,
and the school counselors that I saw, and at that
point wanted to become a school counselor, didn’t
really know what that meant. And could never have imagined working at UC Berkeley in the Counseling Center. – So why is it called mental health? Sometimes incoming students
think of being sick or ill, or these physical symptoms, but you know, a lot of mental health,
you really can’t see it. So, could you elaborate
on some of these hidden disabilities, or different-abilitied
students on our campus? – I don’t think that mental health is the term that we may use in the future. It’s emotional well-being, it’s
how you feel about yourself. We don’t really think twice
about getting our cars a well-car checkup. We don’t think twice
about going to our doctor for a physical checkup. But if it’s mental health, it’s something wrong with your mind,
then you must be crazy, and you see a head-shrinker,
and all of the sudden the stigmatizing language
comes to the fore. We’ve gotta be fine-tuned in college, mentally and emotionally, I think we have to take the charge out of, the sort of electric charge
almost of there’s something wrong with you if you
talk to someone about it. It’s a sign of strength. It’s a sign of resilience
that you would take as much concern for your mental
and emotional well-being as you might for your physical well-being. – And you mentioned stigma, and I know, I actually took your
psychopathology class, it’s awesome, and you discussed stigma a
lot, and what does that mean? Why do you think that the idea of mental health is stigmatized? – Well this is a very long
story, one of my other books is called The Mark of Shame, about the stigma of mental
illness that’s gone on since we’ve really been a species. And throughout history, if people are suffering mentally, and don’t seem as though they’re
as capable as other people, or maybe behave in unpredictable
and even violent ways, that’s very threatening
to a lot of observers. And we stigmatize with
the language we use, crazy, psycho, mentally undeveloped, you can think of all of these terms, and we would really like to, again, put this on a level playing field with your physical well-being,
your emotional well-being, we all need checkups, we
all need to deal with this, much more than thinking you’re crazy if you have these issues.
– [Dree] Thank you. – And I’ll add on that
I think what’s funny is a lot of people say, you know,
mental health is something we don’t think about
’cause you can’t see it. And I always found that
statement to be very funny because you can have a sprained ankle, and I don’t see what’s going
on in your ankle, right? But there are outward symptoms of both physical and mental health. And I see them on a similar playing field. And it’s, again, just like
he said, something that everybody should get checked up on, that no one should feel
like they’re different for having to check in
on their mental health. – I think the thing that
I see a lot from students is this idea that, “Oh I should just “be able to get over it on my own.” And again, kind of using
that idea of the physical, that if you have a sore
throat, you just don’t go, “Oh, I’ll just get over it.” You go, you use the
services and the supports available on campus. Even if you’re struggling academically, sometimes you can study
harder, be more efficient, but you also have access
to GSIs and professors, and drop-in hours, and
you use those services. You don’t just kinda go,
“Oh I’ll get through this”. – So what’s the line between you know, I haven’t slept in a few days,
I’m just tired and cranky, to full-blown symptoms
of poor mental health? How does a student know? – It’s the same issue as blood pressure. What’s the point of your
systolic and diastolic blood pressure, which
is a little bit high, or it’s in the pathological range? The same is true for behavioral
and emotional symptoms. There’s an arbitrary cutoff. But when you’re impaired,
and you’re suffering, and your performance
isn’t what it should be, that’s when it’s time to get a checkup. – So Madison, you bravely
mentioned that you worked out your own mental health. How do you as a student leader, do you ever feel stigmatized? And what’s your advice for students that might be scared to seek help? – Well I’ll say it took
a lot of support from my friends, from my partner at the time, to really go out and seek services, so it’s not just about, what
I would encourage students is, even if you feel like you’re
in a kind of cruising path for your mental health,
look out for your friends. Look out for your partners. Because it was their
support that got me to go seek services in the first place. – Can I ask you to
clarify, what do you mean “cruising along the
path of mental health”? – Well, you know we have bumps in the road with our mental health every so often, maybe you have a test coming up, and you’re a little nervous
for it, but in general, not every day waking up and having just an overwhelming feeling of sadness. Not waking up and not
being able to control your thoughts and body because of what’s going through your mind. I would say that’s at a point, and that’s at a point where I was, where I was crying every night, where I was having to take breaks to sit in the bathroom, to be alone. And I know I’m not the only
student that’s going through it. – [Dree] Absolutely. – Well this is a great way to kind of, there’s such a continuum,
and I think we know that, I can almost guarantee that
all of us sitting here, at some point have felt sad, or nervous about a test or a lecture or something. I would probably think that
many of us would have at some point thought, “Oh wow,
did someone just say my name?” when no one was there. You know you leave the
house and you think, “Oh did I lock the door?” And so you go back. That doesn’t necessarily
mean you have depression, anxiety, obsessive-compulsive disorder. But there’s a continuum,
I think that as you have more symptoms, as you have
more impact on your life. And when it starts to
get in the way of your, for students it’s gonna
often times be academics, but it can also be personal
life, relationships, your dating life, your family life. When the symptoms start to kind of, kind of impact that, that’s
when something might be going on, and it would be
worthy of an assessment. – We used to think that you
had a mental health condition or you didn’t, even in the DSM, you’ve got a disorder or you don’t. The science now shows us,
everybody’s on a spectrum. All these symptoms are on a spectrum. And where the cutoff is,
really depends on the suffering involved, as
much as the symptoms. – And what are the most
common symptoms or, what are the most common
ailments plaguing, if you will, college students? What do you usually see? – Well when we look at
the top three reasons why students come to
the Counseling Center, and this is actually nationwide. It used to be depression, then anxiety, and then academics. And now it’s actually anxiety, depression, and academics and relationship are kind of on the even keel in third place. – [Steve] And I would
think attention problems are high up there too.
– Absolutely, and attention problems kind of span, you know if you’re having some, and when I say anxiety and depression, I distinguish between the
adjective anxiety and depression, and the clinical disorder. You’re having some symptoms but concentration can be a problem with sadness or depression,
nervousness or anxiety. – Aaron, can I ask when you say, the academics and relationships, what does that look like
for the average student? – I think often times it’s break-ups, in terms of relationships,
someone will feel really overwhelmed with
maybe chronic issues that created a breakup, and so
that might be one piece of it. In terms of academics, it
often times is concentration. Students are saying, “I’m
having trouble focusing, “I’m having trouble staying connected, “I used to be able to read a
page, and now I read the page “and it goes from one ear,
it goes out of my head. “I’m going to my lectures,
but all of the sudden, “45 minutes is over and
it’s like I wasn’t there.” – It’s a lot of self-talk too, is what I’ve learned from my experience, Is I can kind of tell where
I’m at with my mental health, based on how I talk to myself in my head. So if I’m saying, if I’m working
on something really hard, and I say, “Oh wow you’re so
dumb, why didn’t you get this?” I know maybe I’m not in the best place, and I should be seeking those supports. Whereas for me, when I
said, “You know what, “this is hard, you’ll get
back to it, we’ll work it out, “you’ll get a friend,
we’ll get through it”, then I know I’m in a better
place with my mental health. It’s a lot of how I talk to myself. – Steve, you talked, you
made specifically the point about attentional problems, and Aaron made the helpful point that it spans across the different issues
we’re talking about today. What does attentional problems refer to? – This is like a symptom in medicine. I might have a fever, and there’s a hundred causes of that fever. I could be having poor
concentration and lack of focus because of depression, because of anxiety, because of something called ADHD, where this is a more primary issue, because of earlier
trauma I’ve experienced, just because of the
stress of being a student, because of relationship problems, it’s really non-specific but it is a very pertinent symptom because this is what college is all about, organizing and executive functions, and paying attention
and getting it together, and whatever the specific cause, attention problems can
really get in the way. – Absolutely, and in that same vein, when you start to feel these symptoms, if you can recognize them,
or friend says to you, “Hey, you’re not acting
the same, what’s up?” And you do decide to seek counseling, where do you go first, what first? – I should probably handle that one. I think there are a number
of ways to get connected. Counseling and Psychological Services is one of the main counseling
services in the Tang Center. And the easiest way to get
connected would either be to walk into the Counseling
and Psych Services office, or call us. And at that point, often you’ll be asked, is this an urgent issue? If it’s an urgent issue, we want you to come in as soon as possible,
and we have walk-in hours. If it’s not urgent, we generally
will set a student up with either an in-person or a phone, what we call a triage assessment, which is just a short
way to kinda find out what a student is
wanting, with the goal of, in a collaborative way,
working with the student to figure out what would be
the best option for them. So really on this campus, Counseling and Psychological Services is the main option, but doesn’t have to be the only option. There are many students
who utilize services outside of the university,
with their insurance. I will often encourage students
to seek out other supports, whether it be their
friends, the student groups they’re involved in,
religious organizations. – One quick point of
clarification for our viewers, who are new to the university, where is this service located? – The Tang Center is 2222 Bancroft, and it’s the main
University Health Service. And Counseling and Psychological Services is up on the third floor. You get off the elevators and
go all the way to the left. – I don’t mean to put you on the spot, is there a website or a specific term to type into a search engine? – You know if you just say UC Berkeley Counseling and Psychological Services, that will get them there, absolutely. – Can I cut in with just a
point related to all this? Why would the college
years be such a time for these psychological, mental
health, emotional concerns? For many students first,
this is the time that you’re away from home for the first
significant amount of time. Second, the stress level
has never been higher. And third, around the world, whether you’re in college or not, the teen and early
adult years are the time that evolution has created,
of onset for significant concerns with depression, anxiety, intensification of attention
problems, et cetera. So it would be no surprise
that this is a difficult adjustment for many people,
but putting on the sort of bravado of, “I’m above it, I
don’t need to talk about it”, is the wrong attitude. – Or, “I’m my own person,
I’m independent now, “and I’m out to prove something.” It’s also important to
point out and recognize that the first two stressors
that you talked about, mainly the big stressor of being at Cal, can be overwhelming
even for older students. Even for student parents.
– [Steve] Absolutely. – Who might not fit into
these adolescent categories. – Well and I would encourage
students to really see us sometimes that word counseling,
it fits into the stigma, Counseling and Psychological Services. I would really encourage students to see us as a support service. We have a significant amount of students coming in each year for career counseling. Help trying to understand what kind of major they want to choose. What kind of career path
they want to choose. Adjustment to college, we see
a lot of first-year students, who are, the word is homesick,
it’s just a big transition. So you don’t have to come
to the Counseling and Psychological Services, you don’t have to wait until you’re depressed, I often say that stress leads
to sadness and nervousness, which leads to depression and anxiety. Let’s have you come in and
utilize the support services when you’re feeling stressed. – Aaron you made a great point about, for example, a relationship breakup. And that just reminded
me of your earlier point about the perception that the cause is out there, and I
should deal with it on my own, and I should get over it, it will pass. Whereas I think the message
that we’re hearing is that the services that are offered are there precisely for those moments when you are feeling down, when you are feeling incredibly anxious. – Absolutely, and what I would do is, again, I think the idea is
that everybody’s an individual. And so what I would do
is have students kind of think through, are their
normal support services, are their normal coping
mechanisms working? And so if there’s a breakup
or you have your first negative experience with
a grade at UC Berkeley, And you get sad, that’s normal. You get nervous, that’s normal. But all of the sudden if three days later, you haven’t come out of your room, you’re not eating really well, your friends are starting to say, “Hey what’s going on,
we’re worried about you”, that’s when we may be
a really good option, again to come in, be
assessed, kind of think collaboratively about what
might be helpful for you. – I’m gonna push the metaphor again. Don’t wait for your car
to have the transmission fall out and the exhaust
pipe dragging on the ground. At the first sign, this
is when social support, and it could be peer to
peer, it could be groups like Active Minds on campus, or
Let’s Erase the Stigma groups, starting up in high
schools in the bay area, we’re gonna try to spread
to college campuses too, where it’s support around
mental health and stigma, that may not be one-on-one
therapy, or counseling, per se. – Steve, you said something earlier that I really identified with. A lot of students on this campus don’t necessarily
recognize, they have this “I’m above needing counseling”. And what I’ve noticed is that
manifests itself often in self-medication, alcohol
use, other issues. A lot of students these days
are abusing study drugs, just to do well in class. What do you all have to say about that? What are your thoughts
on this self-medication culture we have? – Well I think it’s a product of the environment of Berkeley, I think that Berkeley is at times, an
unreasonably demanding environment. But of course, what I would
say is that I would really not encourage self-medicating. Because it often ends up
putting you in a worse place than you started out in, and
that’s totally not the point. The point is you wanna feel better. You want to get your mind off of it. And this actually, in many
cases, brings you a step back. – I wanna say something
specific about smart pills, study meds, stimulants. I do some work in the ADHD area. And the number of college
students here and elsewhere, even the number of high school students at academically-pressured high schools, using their friend’s or
roommate’s ADHD medications is really alarming. And you could say, well what’s the harm? Everybody’s gonna get a
little smarter on these pills, everybody drinks coffee. Well these stimulants, A,
are pretty effective if you have bonafide ADHD. B, will keep you up a little
bit later if you don’t have ADHD, but don’t really
affect your learning. There’s clear evidence
that that’s the case. But C, if you don’t have
ADHD and you’re taking these occasionally as study
aides, the risk of getting addicted to these meds
is very significant. And it’s not a pretty picture so we could talk about alcohol, marijuana, other illicit drugs as
well, but in terms of the stimulants as smart pills, the evidence is now showing
us they’re not smart pills. – What about alcohol? What’s the incidence of use to alleviate stress? And what downstream effects do you see? – Well I know that we will see students, that it’s sometimes hard to distinguish, did they start their alcohol
use as a coping mechanism for the anxiety or the
depression, or did they, or the other way around? And sometimes it’s, again,
it’s very individual. So it’s hard to make a
blanket statement on that. But we definitely are seeing
students who are saying “The only way I feel like I
can go to sleep is to smoke”, and so on and so forth. – And we know that there’s
genetic vulnerabilities that differ across people. Some people will handle a lot
of stress pretty resiliently, other people, often with family histories, will get into problems
with alcohol and drugs, or get into problems
with major depression. So it’s individual vulnerability,
the stress of college, but it’s how you cope with
it that’s really essential. – And each student has
their own relationship, each person has their own
relationship with drugs, including alcohol. And I think we hit on
the key point which is to not use it as a coping mechanism, but to really determine for yourself, in a non-coping way, how
to interact with drugs. – And I’ll just mention that
in another segment we explore the issue of alcohol
awareness and responsible use. Let me move on, given that
we’re running out of time, to the issue of proactive
steps that students can take to maintain mental health
and emotional well-being, as you’re saying Steve,
any thoughts on that? – So the first thought
is, physical well-being is an inextricable part of mental well-being. Keep up your exercise,
keep up your meditation, keep what you do to keep
yourself healthy physically, that will have spillover mentally. Number two, take the advice of this panel, and think of well-checkups
and getting some help not as a sign of weakness,
but as a sign of strength. – Yeah I would use anticipation, anticipate the kinds of things that may be stressful for you, so you can start to plan out how you might combat them. I would use the word engagement. Don’t be a passive recipient of your education here at Berkeley. Engage in your academics, and then, you used the word resilience earlier, that’s one that’s huge, you know, we know that students
who are more resilient, they’re better at problem-solving, they have social connections, that they bounce back when
something bad happens. – And yet, Aaron, resilience
is often so thought as an internal, given quality, oh my gosh, that person is so resilient. – “I was born resilient!” (group murmurs in agreement) – But you’re shaking your head. – No, you can learn it, and you can build it and you can stimulate it. Absolutely. – Great, and in terms of Counseling and Psychological Services, or CPS, if I’m a student or I have a friend who would like to go
there, do we just show up? How much are appointments? What about insurance? How do you handle all of that? – Sure, absolutely, again,
whether it be by phone, whether it be walking in
person down to the Tang Center, the University Health Service, and coming right into our office, all students regardless
of health insurance, and sometimes students
get confused about this, and they shouldn’t. All students, regardless
of health insurance, have access to Counseling
and Psychological Services. One of the things that
we’ve really tried to do is keep finances out of being a barrier. And so the first five sessions at Counseling and Psychological Services, including the initial
assessment, are free. But all students have access
to up to eight sessions. And so that’s really important. But the other piece that I
think is equally important to just touch on, is that we are a short-term counseling center. We are very much a problem-solving-focused counseling center, we want to
assess what’s going on for you and make some recommendations. If there are more ongoing
issues that need to be attended to, or someone
is wanting consistent treatment throughout a semester, then the reason that students
are asked to have insurance is to cover these kinds of things. And I know that the students,
at least on our SHIP insurance have absolutely wonderful access to mental health providers in the community. – What I’ll add on is, I’ve
been the student that’s called in for emergency counseling, walked in for emergency counseling, used my five free sessions,
and I wanna highlight again, five free counseling sessions,
regardless of insurance, regardless of documentation
status, I used all eight, transferred to a local
provider in the Berkeley area, through the help of Counseling
and Psychological Services to find that person. And have also been a
part of group counseling at the Tang Center which
is an option as well. – Yeah can I touch on,
I’m glad you said that, because each semester we offer
anywhere from 15-20 groups. And some of our most successful groups, if we wanna talk about this
idea of getting ahead of this, right when you have the stress, are our stress-management groups. They’re anywhere from
six to eight-week groups, they usually will start
kind of in the first month of the academic semester. And they’re a wonderful
place to meet other students who are experiencing similar issues. – And there are
identity-based groups as well. – Absolutely. We have both what we
call skills-based groups, where students are learning skills, addressing those negative self-thoughts, learning mindfulness and meditation, and we have what we call process groups. Understanding self and other,
just trying to understand how relationships are building. And we have groups for
students who identify as LGBT, and a number of other groups,
really a great offering. – And Madison, where do students
go to find these groups? – Yeah, so you can walk
in to Counseling and Psychological Services, and
they have a bunch of really beautifully-colored flyers. For some of the groups, not all of them, you have to be seeing
a counselor regularly. You can also find them online, I believe, at the Counseling and
Psychological Services website. – And just one more online, I have to push one more online thing,
our Be Well campaign. Which is really about proactively getting ahead of the
curve, it’s about wellness, it’s about gratitude, it’s
about positive psychology, and you can get to that
through our website as well. – And just briefly, really quickly, I know that i hear a lot of students say, “I’m just so stressed, and I’ve
reached out to my professor, “and they just don’t understand.” What is your advice for a student? How do they approach that
in the academic sphere? – So, go to multiple places. Graduate student
instructors, peer to peer, informally or formally,
some professors are more equipped than others,
find your support network. I think the big issue
is, this time of life, when most people go to college, is the time of maximum strength,
physically and cognitively, it’s the greatest time of your life, and it’s the time of most
risk for substance problems, emotional and behavioral problems. And taking this proactive
approach will go a long way. – We’ve covered so much ground today, and I’d like to conclude by
asking you to think about that one piece of
information that you would like our viewers to take with them throughout the rest of their careers. Something brief, a quick nugget. Madison, let me start with you. – Yeah, well I think something
that I’ve wanted to say that hasn’t been said is,
counseling isn’t the only way to take care of your mental health. We’ve mentioned physical
health, meditation, support groups, identify groups, if you’re a part of a certain
identity, reaching out to student and peer groups can be
really helpful, acupuncture. So there are lots of
different kinds of ways to take care of your mental health. And when in doubt, take care
of yourself, you’re number one. – Yeah I would say use the
resources, UC Berkeley is a wonderful institution
when people are proactive. UC Berkeley works a
little less efficiently when we’re reactive to things. We want students to be proactive. – Thank you. – If you don’t work out
physically, your muscles atrophy. If you don’t proactively work
emotionally and mentally, your well-being atrophies. This is a muscle, it’s a skill, it’s not something
you’re born with or not. – It becomes something that you train until it becomes a habit. A vertical theme throughout our series. Let me thank Stephen
Hinshaw, Madison Gordon, Aaron Cohen, thank you for being here, and thank you for watching. (soft instrumental music)

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