Watching Mental Health Episode 1 | Dr. Sheldon Jacobs

This is a transcript of Watching Mental Health Episode 1 with Dr. Sheldon Jacobs which you can watch and listen to here:

Katie Waecther: Hi everybody. Welcome to my first episode of Watching Mental Health. I'm so excited to be here and to be doing this, and this is your place for all things mental health. So on this show, we're going to be breaking down the stories, the research, the stigma, and all the stuff around mental health. And we're going to talk about treatment and recovery with providers, professionals and those with lived experience. And I am very excited because on this very first episode of watching Mental Health, I have the distinct honor of interviewing Dr. Sheldon Jacobs, who is a licensed mental health professional advocate, educator, speaker, author, consultant in the mental health space. Dr. Jacobs has worked in inpatient, outpatient and private practice for over 15 years and is also a media consultant here in Las Vegas. I've personally seen him on channels like P B SS Las Vegas. 

I've seen him with the review journal, Fox five. Dr. Sheldon also serves on the state of Nevada Board of Examiners for MFTs and CPCs, as well as serving as the vice president of the NAMI Southern Nevada Board of Directors. And he also is the very first Nevadan that's on the national NAMI board of Directors. So I'm very excited to be introducing him today. And so with that, I'm going to go ahead and bring on Dr. Sheldon Jacobs and have him talk a little bit about himself. And so Jacobs, Dr. Jacobs, thank you so much for joining me for my very first show. And like I said before, I'm just really honored for the opportunity to interview you. You have done so many amazing things here in the community and with mental health. And so with that, I just want to just start off by asking you a little bit about yourself. So tell us who you are in your own words. 

Dr. Sheldon Jacobs: Yeah, so first off, thank you for having me and just congratulations for your show. This is big. I think it's so important that we have and create these different spaces when it comes to spreading awareness from mental health and talking about mental health, because that's how we're going to build a chip away with the stigma is by having these conversations and meeting people where they need to be met as well as walking alongside of them. So just a little bit about myself. Let's see. So I think the biggest and most important role for me is just being an advocate. I care very dearly about mental health, and I think a lot of it has to do with my own trauma. When I was 14 years of age, I was nearly killed in the drive-by shooting. And the trauma from that incident has never left me. 

Just, I'll say over the last couple of years, I have been more open about sharing that journey because I've learned that the more I talk about that journey and just my own trauma, the more people feel comfortable about sharing their own journeys as well as feeling more comfortable just seeking help and support. And so that's why that's important to me. But for me, it stemmed from just my own recovery journey, like going to therapy, being the therapist for the first time, and really understanding what was going on with me because for decades, I didn't know what was going on with me. I was having these flashbacks, I was having all these residual effects from the trauma. And because I was trying to conceal what had happened for my family, because at the time I was involved in the gang, when the traumatic event happened, I was involved in the gang and my family didn't know any of that. And so I had to keep everything to myself in terms of that traumatic event because if I would've shared with them that a rival gang was trying to take my life and then it would've eased a bunch of questions and it would've been I feel more traumatic for my family. And so I was trying to protect them. And so doing, I realized also during recovery, that probably wasn't the best thing because I suffered as a result of not sharing my trauma. So just a little bit about me, 

Katie: I really appreciate you just jumping right in because as you mentioned, it can be a struggle to talk about your mental health story and that stigma. It seeps in, I think even to us as advocates and professionals, and we have to remind ourselves that it's okay to talk about our stories and that a lot of people have maybe gone through experiences that are tough, and by us sharing it can help them to open up and to just know that they're not alone. And so I really just appreciate you saying that. Can you tell us a little bit more about maybe what the diagnosis was or what that experience was that the trauma or the mental health challenge that you experienced from that? 

Dr. Jacobs: Absolutely. So after the incident, I was experiencing these flashbacks I was experiencing and avoiding behavior. So the area where it occurred, I was trying to do my best to avoid it, but it was hard to avoid it because my grandparents lived a few steps from where the traumatic event occurred. So I couldn't avoid going to my grandparents' home. Every time my mother would take me to my grandparents, I would start experiencing these symptoms. And for years, I had these flashbacks. I had these very uncomfortable dreams or nightmares, whatever you want to call it.  

Katie: At the time, did you understand that those were symptoms of a mental health condition or were you not sure what was happening when you would have these moments? 

Dr. Jacobs: I didn't have a clue. I knew there was some connection to the trauma. I did know that, but this is going back, so I was 14 years of age. This is going back to I think 92, 93. So trauma wasn't really talked about on the level that it's talked about today. So there were just a lot of unknowns for me. So no, I didn't know what, I knew something was going on for sure, and I knew that it was connected to what had happened, but that was the extent of it. And then when I opted to go to graduate school, we had to see a therapist. Well, everyone in the program had to have mandatory counseling. And so that's when I started talking to my therapist about some of my symptoms and some of the behaviors I was engaging in. And then he diagnosed me with posttraumatic stress or PTSD. 

And one thing about post traumatic stress, and you might hear me say this a lot, so I always take off the knee, the disorder. I think postpartum stress is something that is normal in terms of for anyone who experienced something very traumatic, you're going to have these residual effects or symptoms as a result of that trauma. So for someone who maybe experienced something very traumatic and didn't have residual effects from that trauma, I would be a little more concerned with that individual versus somebody who's having these symptoms as well of that trauma. So I think talking about stigma, talking about labels and how powerful they can be, I always referred to post-traumatic stress disorder as just post traumatic stress. And that's something I learned a couple years ago from a police officer. A police officer here in the community had me on a panel discussion. I was having a panel discussion with this police officer, and he mentioned that, and that was the first time I heard that. This was six years or so ago. I was like, wait a minute. And so ever since I've referred to stress as just that, 

Katie: Yeah, I really liked that. I didn't actually understand why you did that. I have heard you in the past say P t s without the D, and I think that you're absolutely right. We as a society, there's a lot of, I think in our world, and if you go through an experience, a very traumatic experience, a near death experience, one where maybe you've lost a very close loved one, you're absolutely right, it would be unnatural if you didn't have some sort of reaction to that. And I think that there's that line between crossing into a mental health challenge where maybe something more deeply is going on. And then also just recognizing when sometimes life just sucks and sometimes things happen and you have to work through that. And it's okay to get therapy or to seek treatment for even those little bumps in the road, right? Because the bumps in the road that don't get addressed, they're the ones that become big, big things later on and they can build and build over time. And I'm sure you've known that, right? 

Dr. Jacobs: Absolutely. And that's why I think for me, once I was able to go to therapy and I was really able to start my recovery, it was the most sort of healing slash powerful process that I ever endured. And it wasn't for therapy. I mean, I don't know where I would be because again, talking about cultural norms and in my family we don't talk about, especially mental health challenges. We don't do that. And in my family, I learned that there's a lot of people that struggled with mental health and never talked about and never received treatment. And so I realized that I was only reinforcing some of that. And so by me going to therapy, by me talking openly about my mental health struggles, I think that has allowed other people in my family just to start healing and to talk about their own journeys and some of their own struggles. And then looking at our community as a whole, that's something that I do a lot. You alluded to, you always see me on TV or on the news, on the radio, whatever, wherever I can. I'm talking about mental health because I think it's important that we normalize it as much as possible. 

Katie: Yeah, no, I think you're absolutely right. And that family trauma is there and nobody wants to talk about it until finally somebody does. And then everyone kind looks around is like, oh yeah, I've also been experiencing these problems and these struggles. And so that's just so interesting that you touch on that. Tell me a little bit more about how you decided to go down this path. I know that it wasn't until grad school that you actually were diagnosed with anything, but before that, it seems like you had already kind of made up your mind that you really wanted to go down the mental health road. 

Dr. Jacobs: Yes, great question. I think I started, so my aunt, she owned group homes for Alice and boys that had been abused and neglected, so they were boys of the court. And so I started working in her group homes and we had a resident marriage and family therapist, and I kind of saw the work that he was doing with these kids, and I was like, I can do exactly what he's doing and be just as effective as he, or even more effective. I could relate to a lot of the children that we were serving at that point. I started asking him questions about his education, what did he do? And I think that's where I started. So I didn't always know that I was going to go into this field. I wasn't like a psychology undergrad major or anything like that. It was something that I went to college, I had no idea I would be in this field. But I think working in the group home and working with children that had trauma on top of trauma, I think that that's where I was. Those footsteps were kind of laid out for me to go into this work. 

Katie: Yeah, absolutely. That makes sense. When you show up and then you see people who are struggling and you think to yourself, oh, I think I understand. I want to help. And I think that that's so powerful that you had that and that you switched into what you knew was your calling, even though from the get go, you weren't necessarily going for psychology. I think that's really cool. 

Dr. Jacobs: Thanks. 

Katie: Another, just to kind of shift a little bit, you're a professional in the space and I really value your opinion, and one of the hot topics around mental health these days is treatment. There are people who are all pro medication, there are people who are very anti-medication, there are people who are in the middle. I wanted to get your thoughts on what treatment in the mental health space looks like to you? Have you seen, I know with your own experiences, have you seen successful treatment and recovery and what does that look like? 

Dr. Jacobs: Yeah, I would say it depends on the person. I think that you can take five people with the same or similar diagnoses and put them in the same type of treatment, and they all would have a different response to that treatment. And so I think that obviously for some individuals, and first lemme back up. So first of all mental health is a spectrum. So you have people on different varying levels of the spectrum. So individuals that are more like on the, I'll say maybe the end of the spectrum, that's quote more severe, more pervasive. I'll say that for some of those individuals, not all, but for some of those individuals, the medication a lot of times tends to be the most effective approach. Coupled with therapy, I think research indicates that individuals that are receiving pharmacology or medication treatment, that a lot of times therapy is also even more effective when they're also receiving medication versus just receiving medication. 

And so I think that it's important to understand that also when it comes to even therapy, obviously there's various types of talk therapy, there's other approaches like E M D R, there's brain spot, there's so different approaches. And so for some people talk therapy is not always effective. And so I think that sometimes you have to kind of find what fits you. And some of that comes down to even the therapist. I always say that therapy is 70 to 80% of the relationship that you have with the therapist. So if you have a great connection with your therapist, the other stuff will kind of follow suit. The interventions, the strategies that are utilized in treatment, will come together. But I think that relationship with the therapist is so important, and sometimes for some people they may not find that right fit right out the gate. 

It might take two or three different therapists before you find that right person. So one of the things I want people to know is don't get discouraged because a lot of times what I hear is somebody might see one therapist and this might not be a good fit, and then they kind of give up on therapy and therapy completely. And I kind of equate it to going to a barber or a petition or a nail shop. You have to try different ones or different people before you find the right fit. And so I think when it comes to therapy, really it's the same thing. And so just don't give up on it. It's a very effective mechanism if you have the right fit. 

Katie: Yeah, no, I agree with that. And I think you're absolutely right. It's mostly the relationship. I didn't realize that it was probably 70 to 80, but I think you're probably right. If at the end of the day you can do all the great interventions, but if you don't have that relationship, then it's not going to work. Here in Las Vegas, I have personally seen people really struggle to access therapists. And so they'll spend six months trying to access a therapist, maybe through their insurance, and then they finally get one, and then it's not a perfect fit, and then they kind of give up because it's hard. I mean, frankly, and if you're struggling, it can feel even more challenging to put yourself out there and to keep looking for access to help. What do you say about that? I know that here in Las Vegas, you have seen a lot yourself. 

Dr. Jacobs: Yes. And I tell people, if you have that problem, reach out to me. You can find me, my email, website, dr she jacobs.com, reach out to me if you're having an issue located a therapist, if you're on a wait list, whatever the case may be, reach out to me. I've taken that on because that is something that you're right in this community in particular, Las Vegas, I hear that all the time, and that should not be the case. Nobody should be, first off, nobody should be waiting to see a therapist for four or 5, 6, 7 months. That's totally second these therapists, and I'm talking to all your therapists out there, if somebody's calling you looking for services or wanting services or needing services, please call them back. That's another issue that I've been seeing a lot of times is people, they just Back. Don't call back. No, I can't tell you. Every week somebody reaches out to me and has that complaint. That's unacceptable. So we have to do better as providers as well. There has been a lot of talk regarding there not being enough providers in the community, and there's some truth to that, but I'll also say this, there's a lot of providers that only accept cash pay. There's more providers leaving MCOs because of managed care options or insurance companies. They're leaving these insurance companies because the rate is, the reimbursement rates are low for some or all time reimbursements. So for a lot of providers, this is their income, this is how they earn their living. And so if you're not getting paid, you're supposed to get paid, that can be a problem. So there needs to be more accountability held for these M C L companies. 

They have to do better, not doing a good job when it comes to that piece. But yeah, there's a lot of providers that are just cash pay and their rates a lot of times are pretty high. So the average person probably can't afford therapists out of pocket because of how expensive it's, and also individuals that have insurance, sometimes the copays can be high, sometimes the coverage can be low mean. So talking about parody and these other issues, which is a discussion for another day, but there's mental health space that we need to do a much better job at. And so there are some folks working behind the scenes to address some of these issues. Also, some of the workforce issues as well when it comes to providers. So there's some things, there's some bills that have been passed where we're trying to address some of these issues. 

Katie: Yeah, I think that's absolutely true. It's an issue, but it's one that we are trying to address. And you're right, there was some legislation passed this year, so hopefully that'll help keep our mental health providers here in the states. And I mean just in general, it's a system-wide problem in many ways. And I know that we're not the only place in the country that kind of struggles between that battle of mental health providers and insurance companies, frankly, because those parody laws, it's still an issue and I know it's when we're still working to get through. I know that you said that you're working behind the scenes. What kind of work are you doing? I know I've recently connected with a few groups that are actually doing full on mental health professionals just getting together just to talk about these problems and work through them, and they've been very insightful meetings. But for me, I'm kind of wondering as the lay person, what's next? What action can I take? I know that we've just had our legislative session, but maybe even reaching out to our policymakers. What are some of your thoughts on that? 

Dr. Jacobs: Yes, no, I agree. Definitely reach out to your policy makers, know who those individuals are. I don't realize there's so many people who do not know who their elected officials are. So I think it's important that you do that research. Find out who those individuals are. One thing about Nevada is our community leaders or legislators, they're very approachable and accessible. You don't have that in a lot of other states. That's not the case. I agree. We do have that accessibility. I think it's important to reach out to them, and a lot of 'em are proponents of mental health. So I think that just continue, just to keep that door open as wide as possible is important. Also for me, I've been involved in several work groups across the state, also just through nami, national work groups and things that are happening at the national level. 

And so I'm excited to share there's going to be a lot of changes that are going to be happening over the next couple of years, even within the workforce space and jobs and corporations and how mental health is approached and talked about and looking at peer-to-peer support and accessing that resource. And so there's definitely a buffet of issues and things that are being worked on. Obviously unfortunately, some of those things is not going to be overnight, unfortunately. But again, just trying to stay connected, try to stay involved as much as possible. I know for me, sitting on various boards, participating in various committees, work groups, those are things, coalitions. I created a coalition a couple of years ago for clinicians of color where we come together several times a year and we talk about some of the issues going on in our community, and how to address them. So again, just trying to do my part as much as possible to really just change this narrative as it pertains to mental health. 

Katie: Yeah, absolutely. And it's an uphill battle. I mean, I know it is, but like you said, things don't change overnight. So it's on us to keep these conversations going and to just keep showing up. But on the other side of that, there's a balance. I know that we can push and push and push and push. And as mental health providers, I know that you often want to be there for that next person, but really self-care is essential, filling your own cup. So I just want to have a few minutes left. So talk to me a little bit about what self-care for a mental health provider looks like for you and what you think it should include. 

Dr. Jacobs: Yes, it is funny you mentioned self-care because I hear my wife just yelling at my other ear, talking about talking to me about self-care. Like you said, I'm involved in so much stuff and I always have to be mindful of that. So for me, a big thing for me is exercise. Exercise is meditation. So I meditate every morning. I every morning and every night I meditate, try to get as grounded and centered as possible. I'm also a big runner, so I run about 20 to 25 miles a week. Wow. Really helps me to get my mind focused. 

Katie: Do all these things and you run 25 miles a week. That's amazing. 

Dr. Jacobs: Yeah, about the morning. So I wake up about 3:30 AM Monday through Friday and get to the gym, get on that treadmill, and that's how I start my day. And so that's how I'm able to keep my cup full is by taking care of myself as much as possible. I say exercise, meditation also just I have a great family, great support system. So if I'm dealing with something or if I'm stressed out, I can go to my wife, I can go to my brother, my parents. So I have people in my corner that understand me and are there to support me. So I think that's also important. And for therapists in particular, we do oftentimes vicarious trauma. So when you're treating somebody and you hearing their trauma and it affects you. And so I think that as therapists, I think it's very important that we are intentional and mindful about how we are being impacted and really just staying in tune with our own bodies and physically, mentally, spiritually, even. I think that's very important. If you're not in tune with what's going on with your body, then you're going to have a lot of difficulties as a result. So for me, constantly, it's a daily process for me in terms of staying centered and grounded. 

Katie: Yeah, absolutely. Every day it is important to take those moments to make sure you don't burn out and that you can still show up in your best, most authentic self. Absolutely. And I love what you said about having a support system. I think that's so key. Us as human beings, we're social animals. I say this all the time, and so we need people around us. And I even say this as an introvert, I love my alone time, but I also recognize I need my support system. So I just really appreciate your time. We're about at time here, but I want to leave with one last question I want to ask, and I think that I'm probably going to ask this question at the end of most of my shows because I'm interested in this. And so this question is, do you think that a mental health challenge or a diagnosis is something that you can overcome or something that you should learn to live with or accept as a part of you? 

Dr. Jacobs: That's a good question. That's a loaded question. Wow. I'll say it like this. I usually will leave it up to the person because, and the reason why I say that is because people have different views on mental health. And I give you a case in point. So I have three people in my life that I'm close to. One of 'em was my cousin who was diagnosed with paranoid schizophrenia when he was about 18, 19 years of age. Then I have two colleagues, one of 'em, which I've been connected with through nami. And one of 'em has a severe form of bipolar disorder, so bipolar disorder, psychotic features, and other one has also has schizophrenia. So three of 'em have severe mental illness for S M I. And all three of them have different views of their own Mental health. 

So my cousin says that he doesn't no longer have schizophrenia because one thing, he's not being treated for it anymore. He has not taken any psychotic medications in years. He's doing really well, very well adjusted. But then my friend that has bipolar disorder says that I have a mental illness, I'm mentally ill. And then my other friend who has paranoid schizophrenia says that no, mental health is fluid. Sometimes I'm going to struggle with other times when I'm not. So again, so a good case in point in terms of how people view their mental health. And so for me, I was diagnosed with post traumatic stress and from time to time I had might experience some challenges connected to that, but for the most part, I've learned the work with it through just the therapy that I've been through and the mechanisms that I've put in place to help me. 

And so for me, I say that mental, mental health, I see it as fluid, meaning that, yeah, I was diagnosed at one point in time. Do I identify with that diagnosis? Not necessarily because I've been able to adapt and being able to. So I guess the short answer is I leave it up to the person. I think that depending on the person, how they view their own mental health challenge, it's up to them. For me, I do say that I live a posttraumatic stress because it has not completely gone away. I have haven't had any full remission from it. It's still there. And so I've just learned how to live with it. 

Katie: Yeah, absolutely. That's a great answer. And I think it's true in many ways that every individual has their own thoughts as to if they're recovered or if they're still experiencing challenges and it's a fluid journey. That's just kind of how mental health is. Mental health itself is fluid. Sometimes we have really great mental health. Sometimes it's more of a struggle, but we all have it. And I think that that's the important thing to keep in mind. So with that, I just really appreciate your time. The half hour went by super fast, and it's again, just an honor to interview you and to see you out in the community, and it's an inspiration for me. So definitely you're walking a path that I want to walk as well. It's great to be friends and to call you a friend. Thank you so much for your time. 

Dr. Jacobs: Thank you, Katie. I appreciate you. 

Katie: Of course, this is watching Mental Health. We are going to be live every first and third Wednesday of the month, and I'll have a new guest every single time. It's a half hour show, so please tune in if you can. And then we'll also be showing these afterwards. And so you can definitely catch the replay on my website katierosewaecther.com So yeah, so thank you again, and I'm so excited. This was a great first show and I'm excited to see you guys next time!

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Episode 01: An Introduction to Watching Worry