Will my Kid with T1D have a Normal Life?

With things like checking blood glucose, counting carbohydrates and injecting insulin, it's hard to imagine how your child's life with type 1 diabetes could ever be "normal". Click here to see the video where we show you how a great life with T1D is still totally possible. We’ll also go over what to keep in mind when you feel overwhelmed by what the additional tasks and challenges of T1D might mean for your child, and go over one of the best ways to find a sense of "normalcy" in life with diabetes.

I started a YouTube channel!

Type 1 Diabetes World is officially off the ground!

I partnered with Karen Aitken, a diabetes coach and Nurse Practitioner certified in advanced diabetes management (who has also had T1D since age 10) to use our almost 30 years of combined professional experience working with kids, adults and families living with T1D, to start a YouTube channel!

Why did we do this? Well, we know how life changing and overwhelming this condition can be. Our goal for the channel is to give you the knowledge and tools to help you feel calm, confident and totally able to handle the medical and psychological highs and lows of T1D life.

Oh! And our content is evidence-based, so you can trust that what you’re learning here is backed by research and science.

New video each month on Wednesdays!

All content is intended for informational purposes only. It is not medical or mental health advice.

How to Deal with Diabetes Distress & Burnout

Have you ever felt overwhelmed and just wanted a break from the 24/7 job that is diabetes management? Or frustrated that even when you do everything "right", you still don't get the blood glucose numbers you should? These are classic signs of Diabetes Distress and even it's more intense cousin, Diabetes Burnout.

But why read about these when you can watch a video about them? Click here to find out how to know if either of these are happening to you and how to deal with them.

Helping a Child Develop Emotional Maturity To Care for Diabetes

Last week we talked about emotional maturity and what an important factor it is when caring for diabetes. Now let's talk about how to help a child develop that maturity. The next time your child struggling to make a decision, try having a conversation--but do the listening part first, letting your child talk through thoughts and fears. Here’s the kicker: don’t give advice.

I’ll tell you right now: this will be hard. Children have much to learn, and you want'll want to give every answer you can--especially when not giving the answer could result in a painful and tedious learning process. It’s so difficult not to say, “You’re scared to give a shot in front of people at lunch time? Your real friends don’t care!” Or “Just go to the nurse’s office and avoid it all together!”

But don’t do it. Why not? Self-efficacy can’t happen without your child processing their feelings and thoughts themselves. When you tell a child the answer, you deprive them the experience of figuring it out. More than that, you take away their experience of knowing that they can figure it out.

Of course, sometimes you will answer their questions before they do. But when you can sit back (just a bit), you’re empowering your child to really ponder and research the answers. They often have solutions you wouldn’t even think of: “I’ll get Jill and Sara to stand around me as human shields for privacy.”

How many of us have had to learn our lessons the hard way? Even when our parents told us so, we still had to do that stupid thing. It is so helpful for children (and, ahem, most of us) when someone can listen and work through processes in conversation with them. Focus on giving your child a sense of ownership by letting them lead problem solving. This helps them feel that you respect and have confidence in them, which is a huge building block for self-efficacy. If you believe your child can do it, you’ll make it easier for them to believe they can, too.

Need some extra support? Check out the "How To Talk So Kids Will Listen" for Parents of Kids with Diabetes Workshop or get in touch today.

Age = Readiness for Responsibility?

Wouldn’t it be great if universal guidelines existed for shifting specific diabetes care tasks to your child? Although we have some ideas about when kids should be doing various things (waking up on their own, taking out the trash, dosing for meals on their own), the research (and my own experience as a human with diabetes) shies away from setting specific steps for when to do what according to physical age because we know age is a state of mind. Taking on diabetes management depends on a person’s emotional/psychological maturity level. It’s also dependent on their self-efficacy: their belief in their own ability to successfully accomplish a task. As much as we wish it would, the mere act of turning 18 years of age does not magically equip someone for "adulting". 

Think about it—you probably know someone whose driver’s license says age 40. Yet under that full beard, you'd swear they were an 8-year-old who didn’t get invited to a birthday party. Some diabetes tasks are physically impossible for small children to do, but you’ll get a sense of what your kiddo is ready for as you work together on diabetes. So where is the best place to start as you look at your child's emotional maturity within the context of diabetes? Begin by recognizing and accepting where your child is at, not where you wish they were or think they should be. This can actually be really difficult. Many of us wish our loved ones were further along, which is okay too--but "shoulding" all over someone ("you should be testing more frequently; you should know how many carbs that is!") does not facilitate teamwork--and make no mistake, diabetes is a team sport. It is also important to note the large body of research showing that children who take on too much of their diabetes care too fast end up with poorer metabolic control and more mental health issues, particularly around diabetes burnout. Why? What shoulding will do is create an environment ripe for shame, alienation, anxiety and depression to bloom. Help your child by accepting where they are right now, and work from there.

Looking for more on how to develop emotional maturity in your child with diabetes? Check out the "How to Talk So Kids Will Listen" Workshop for Parents of Kids with Diabetes  or feel free to reach out! Y

You can also join my free Facebook group, "Independent and Healthy Teens with Diabetes" for those who want ask to questions, share struggles and celebrate successes as a parent of a teen with diabetes who may or may not find themselves on an emotional rollercoaster that shoots up and down like a blood sugar after late insulin delivery for 3 ½ pieces of a grocery store sheet cake.

Get Bigger To Feel Better

Do you ever just want to drop kick diabetes out of your life? I was reflecting on this topic as it is a feeling that people living with diabetes can experience fairly regularly. The newly diagnosed who are getting used to the necessitated changes and additional duties to daily life as well as the veterans who have years of experience and still sometimes miss the mark (because who are we kidding? The mark can have a mind of it's own!), and all those who undergo burnout in between--we all feel it. Even if we can appreciate how diabetes has made us stronger, we still often wish we could just tell it where to go. The problem is, there's no one to scream at. Getting mad at diabetes is like throwing a pebble at an armored freight train going full steam--nothing makes a dent. We can feel like we have no voice and if our feelings don't have anywhere to go, that animosity we'd like to express to diabetes can turn inward. If it stays inside, with no one to react to our pain, to hear us and engage with it, it can be very difficult to release. Think back to a time when you had a disagreement with someone. Imagine how you would have felt if they'd just dismissed you or ignored you. Yes, we want to prove our point but so many times, we just want others to engage and validate our point of view. We want to know that we're getting through, and many times we'd rather have them yell back than ignore us because at least we can feel that someone else has skin in the game. Much like a computer or traffic light (hmm...which are also computers), diabetes cannot hear us, no matter what we do; it's just doing what it does and no matter how much we tell it that it stinks, it doesn't do anything differently. This can lead to feelings of paralyzing hopelessness and clinical depression and anxiety.

So what can we do? One of the most effective things I've both seen and experienced as a way to cope with difficult realities is what psychologist Mary Pipher calls the "transcendent response". It can be so easy to go into denial, compartmentalization or numbing when we feel overwhelmed. The transcendent response entails taking action by becoming part of something larger than yourself. Whether that's attending a small support group or volunteering with a non profit whose mission resonates with your values, time and time again we see ordinary people banding together in the face of natural disasters or traumatic events who "manage to survive by helping each other".

In our daily lives, we cannot change the fact that we have a chronic condition. We still have to check blood sugars, take medication, and split our attention between our bodies and whatever else is happening. But knowing that others have to do it too, that they "get it" and are passionate about sharing their own stories, listening and adding to ours, combating isolation and wanting change as badly as we do can alleviate feelings of powerlessness and despair. Pipher also said, "Acting as if we have hope generates hope". Much like a blood sugar after pizza, hope can raise up and dip again. It is during times like these that, when we cannot hold our own heads up to see beyond the finger sticks to the cure that has forever been 5 years away, it comes in handy to borrow the hope of those around us who have also walked our path. It is powerful and contagious to be in the presence of someone who believes that things can get better. When they share their victories, no matter how small, we have the opportunity to refresh our mindset and renew our hope.

Need some help rediscovering hope? Check out how you can get involved in the T1D community or contact me for a consultation to start feeling better today!

The Importance of Understanding Diabetes Within the Context of Mental Health

One of the most unique and important distinctions about diabetes is that it is primarily self-managed (as opposed to being treated by a doctor at clinic visits). Because diabetes is 24/7, there is a whole other level of constant background noise during the course of every day life. People with diabetes are constantly making choices (which tend to boil down to: do I attend to my diabetes or don’t I?) that will affect their prognosis. They very well may choose the latter, and for a number of reasons. From having just completed a diabetes task (I just took insulin so I can relax for the next hour while I eat dinner) to just being sick and tired of it (I know my CGM is beeping high but I have to pick up the kids, get them started on homework and put dinner on the table) and the many spaces in between, there is usually a a reel of nonstop dialogue from a vigilant part of themselves that is always watching, anticipating, checking in, planning ahead, and whatever else diabetes-related. This part can get tired though, and it's normal for the part who wants the doughnut and cares not what it will do to spike blood sugar to win out sometimes.

As we look at the responsibility that comes with choice, the ability to self-monitor can be empowering because it means that the PWD can, for the most part, affect change in their own health; they are not “at the mercy” of their disease. The other side of this—which is often difficult for folks to understand and validate, is the thoughts of guilt, shame, and fear that can come from not being on top of diabetes. “If only I had taken better care of myself, not had that doughnut, checked my blood sugar before bed, I’d be okay. This is my fault. I should be doing more.”  If you are a parent or caregiver of a child with T1D, these feelings can come on strong in a different way since the stakes are the wellbeing of your child. Parents will make incredible sacrifices to protect their children. Many have told me that they would take child’s diabetes and have it themselves if they could, but diabetes doesn’t make those kinds of deals. Whether diabetes is yours or it belongs to someone you love, this kind of thinking can be toxic, isolating, and complex though not uncommon.

When mental health issues come up and diabetes is in the picture, you need a clinician who can tease out Diabetes Distress from related conditions such as depression, anxiety and general stress. Many symptoms of these conditions overlap (see the chart below) and you need a trained therapist who knows where to look and has specific knowledge of each in order to correctly identify and effectively address whatever is going on.

depression vs distress.jpg

Are you experiencing difficulties with your diabetes and aren’t sure which is causing what or whether they’re related? Perhaps you’re struggling with Diabetes Distress and need some help with strategies to overcome these situational issues. Whichever it is, I can help. Get in touch today.

Why Self Worth Matters for Disease Management

What does feeling confident in your own worth have to do with your ability to take care of your health? Why is self-esteem so important to disease management?

For starters, let’s not take self-love for granted. I know some may cringe at the therapeutic concept of “self love” but really, why would you take care of something you don’t even like? Self-worth is one of the fundamental concepts I often address with the people who walk into my office because taking care of a disease like diabetes is a lot of time and energy to spend on something you don’t even believe has value. So many people, especially those in the thick of adolescence who are developing their own identity within the context of consumer culture are constantly and actively disliking themselves for not being enough (pretty enough, smart enough, rich enough, etc) or being too much (too loud, too different, etc). So really, why would you take on the rigors of this 24/7 demanding condition if you didn’t believe you were worth all that work? Even if your disease does not require that degree of self-management, taking care of yourself can be a lot of work--from finding a good provider you connect with to diligently working your way down a list of medications until you find the one that doesn't give you belligerent diarrhea, you must believe something has worth in order to hang in there and care for it.

The second piece of this is that having a chronic condition means feeling and being different—not necessarily in a good or bad way, but there are things that diseases like diabetes require the folks who have it to do that are not a “normal” part of other people’s days.

Clinical research (not to mention the experiences of anyone who knows or has been a teenager) has shown time and time again that a normal part of adolescent development is the desire to fit in and connect with peers. So unless you live in some magical/horrific place where T1D runs rampant and everyone you know has it, doing things like bleeding in public or stopping in the middle of an avid game of Frisbee-golf to drink a juice can make you feel really different and alone. Many people (not just kids) will do just about anything to avoid standing out, especially when they fear they may be judged (and let’s face it, there’s a lot of stigma out there around chronic diseases, particularly diabetes).  The need to appear “normal” and fit in often means skipping blood sugar checks and insulin doses—not exactly ideal diabetes management.

Those who have developed self-esteem in a healthy way and are able to own their diabetes are far more likely to see themselves as okay and take care of business, even when they are at risk of feeling singled out because they are not as susceptible to what other people think. So how do you promote positive self-regard and up your confidence?

  1. Notice what you do well. We're so good at fixating on where we fail and ignoring or minimizing when we succeed. Whether it’s diabetes-related or not, build on what you're already good at to create momentum. Noticing is a muscle, and many of us could use some targeted strength training. 
  2. Take a frigging break from social media. Studies (and again, experience) show us that being inundated with the unrealistic (yet utterly convincing and wildly compelling) perfection of other people’s lives can lead to feelings of depression. Social media is a great place to compare yourself to others and feel like you’re coming up short.  FOMO, anyone?
  3. Invest in a relationship where you can be yourself. Many of us have things about us that we swear, if anyone knew what they were, they’d run away screaming. One of the quickest and most powerful ways to develop self-esteem is to be vulnerable with another person you trust. We’re often our own worst critic, and you’d be surprised—what is a dealbreaker for us often isn’t a dealbreaker for someone else.

The Importance of "Checking" Blood Sugars

Let's talk about language and how it is significant in the world of diabetes. The way we communicate with our words matters because language is one of the most precise and powerful ways we can describe things and let others know what is going on inside of us. Let's jump right in with one of my favorites: TESTING VS CHECKING. Just like a test in school that you can pass or fail, "testing" a blood sugar implies that there are good and bad results. For most of us, emotions like nervous, anxious, scared and pressure come to mind when we think about taking a test. With diabetes, the goal is a specific range and the variables to control and consider are many. So if you're "testing" 3-7 times a day and every time you are not in that specific range, you are "failing", you might not want to check as often, or you might lie about your numbers for fear of judgment (from yourself or others). Even when you work hard, make sacrifices and do everything you're supposed to do, you are not necessarily guaranteed to get the "score" you want.

"Checking" on numbers gives you information--nothing more, nothing less. Numbers we "check" help us to problem-solve because judgment is not at the forefront of the picture. I once asked a group of people with T1D how much time they spent thinking about diabetes. Then I asked them to parse out how much of that time was spent thinking about the logistics of maintaining diabetes throughout the day, and how much time was spent beating themselves up for not doing things differently. Most said that the overwhelming majority of time and energy went into the latter category. Upon further discussion we determined that when we are not bogged down by judgments, we are able to be more present with what is happening in the moment. This allows us to be more focused on what we are actually in control of so we can take our next steps without blaming or berating ourselves.

Language is important because if we are not mindful, diabetes can be ripe soil for cultivating judgment and shame. The pressure to be perfect is immense and can come from many different places. There is the self-induced pressure of staying healthy and living a long life, and there is pressure to not let others (doctors, family, friends, etc.) down. They worry, not because they want you to feel bad, but because they care and often feel out of control. That said, managing your health for the sake of others (in addition to doing all the other obligatory life stuff) is still a lot to hold. So if we can take some of the pressure off simply by using different language, at least we can cross one ripening agent off the list.

My point in talking about the significance of language is to illustrate that words are powerful, and there is no need to add any additional judgment or shame to life with diabetes. 

Feel like you could use a little more help in this area? Contact me to set up a time to talk.

Diabetes Distress: The Struggle is Real!

If you’ve seen any of my blog posts before, you know I am a huge believer in the mind-body connection. Both my personal and professional experience have shown me that the way the body feels affects our psychological well-being, and vice versa. In fact, the Diagnostic and Statistical Manual (DSM), fifth edition (which is published by the American Psychiatric Association and is the standard classification of mental disorders used by mental health professionals in the United States) agrees! The DSM-5 added both Anxiety due to Another Medical Condition, and Depression due to Another Medical Condition in their most recent edition. And thank goodness! The struggle is real!

Past research has found a high correlation between diabetes, both type 1 and type 2, and depression. However, psychologists William Polonsky, Lawrence Fisher, et al have taken a closer look at this relationship and developed the Diabetes Distress Scale (DDS) to measure and describe the specific ways that diabetes can be emotionally overwhelming. The scale addresses four areas of concern: 1) the emotional burden of having diabetes; 2) the relationship a person with diabetes has with his/her physician; 3) the person’s ability to follow the diabetes regimen; 4) and the interpersonal issues that a person with diabetes might face with family and friends. See an article explaining this in more depth here.

Diabetes Distress is not uncommon by any means, and anyone who has diabetes can tell you that it is a full time job with a unique set of stressors. If Diabetes Distress is getting in your way of living a happy, healthy life, you are not alone and there is help available. Seeing a mental health specialist who understands how diabetes affects mood and energy level (among other things) can be incredibly helpful in getting you back on track. I help people rediscover hope and find peace within themselves—even when it seems like their body and their mind are at war. Get in touch today.

"The Right One"

I recently got married (more to come on that!) and in one of the many conversations recapping the event with my mom, she told me a story she’d forgotten to share during her toast. (Don’t worry—her speech was awesome and very, very thorough.) It was back when I was about 11 or 12 and she was on the board of the Juvenile Diabetes Research Foundation in San Diego. She was at an all-day JDRF training program and Mary Tyler Moore’s husband (who is pretty well-known in his own right for being a rockstar cardiologist) was one of the speakers. I had been diagnosed only a few years earlier and after turning over all of the information she’d learned about the burden that diabetes can be, she couldn’t help but wonder if the disease would not only threaten my body, but also break my heart. I’ll explain—in a stolen moment from the crowd during a break, she told him, “Your wife is so lucky to have you. I worry that my daughter will grow up and some day fall in love with a man, and he will not want to marry her because of her diabetes.” And (now this is her favorite part!) he said, “Then he’s not the right one”. She says that after that, she felt immediate relief. Sure enough, low and behold, the right one did come along! And he has more emotions about my lack of sportsmanship when I lose to him at Dominoes than about the fact that I have diabetes.

No Words

I was waiting in line at the post office today and saw that the woman in front of me had an insulin pump. I got really, really excited, tapped her on the shoulder and pointed to my own. She smiled, and then it was her turn to see the clerk. I found myself smiling as well because I felt as though I had met a kindred spirit. We didn’t even talk about diabetes—in fact, we didn't say anything to each other! If anyone loves processing and talking about emotions, it’s me. But here, there were no words and sometimes, there doesn’t need to be. Something in me connected with her, and that feeling is invaluable. 

Why Camping is Good for You (written by an un-out-doorsy person)

When was the last time you went camping? I don’t necessarily mean in a tent but do you remember what it was like to go to an actual camp with cabins, campfires, counselors with funny nicknames, silly songs and, well, “camp food”? I went to Camp Leo’s Family Camp on Memorial Day weekend and it was AWESOME. I’ve never been one for sleeping in bunk beds and I’ll admit, it’s been a few years since I was last what you would call a “camper” (and even this time, I wasn’t technically one as I was “staff”), but I found myself swept back to the time when I was one. And this one was even better because 1) tons of people, including the counselors, had type 1 diabetes (like me!) and 2) it was a family camp! Don’t get me wrong—as a tween/teenager I was usually more than okay with having separation away from my parents (who worried about me because I had a chronic medical condition and were unsure leaving me in the care of others—which tended to get old), but sometimes, I’d miss them. This camp was the best of both worlds because it included hanging out with friends (under the supervision of fun, responsible people who understood diabetes and how to treat it) while parents learned about 504 plans, exercise considerations and emotional issues tied to diabetes. Everyone got to connect with people who knew what they were going through, and they got to have a good time. Whether you’ve never “camped” before as a family or you’d just like to meet other people who experience the same kinds of things that you do, I highly recommend it.

"You don't knooooow me"

I remember once when I was in high school I got a low blood sugar in the middle of class and went to the vending machines to get a Snickers. Like any normal person with type 1 diabetes experiencing a low, I was wolfing it down and taking no prisoners, and my P.E. coach walked by. I so engrossed in my ravenous, shaky hunger that I barely noticed him. But later that day when I was in his class, he called me out in front of everyone: "I saw Kintner this morning demolishing a candy bar and I thought she was going to eat the wrapper!". In his mind, he was making a harmless comment that I'm sure he thought was hilarious, but I. Was. Mortified. What a huge jerkwad! I'd like to see him handle a low blood sugar. He didn't know me or what I deal with! It really ticks me off when people should know better and don't, especially when it's at my expense. This makes me think of the quotation: "Everyone is fighting a battle you know nothing about." Amen, Plato! He nailed it. There is no sign on my forehead that says I have diabetes (although there may be box of juice in my hand!), and oddly enough, this can be frustrating because although I don't want to be defined by or treated differently because of my diabetes, people not knowing leaves me open to feeling misunderstood, judged, and like a victim of ignorance. This being said, a few years later I attended a workshop with a dear friend and her phone rang right in the middle of it. She noisily left the room, gathering several large bags and bumping into people as she stepped over them to leave. When I spoke with lecturer afterwards, he expressed that he was quite offended that my friend would leave in the middle of his presentation--it was disruptive, loud and he felt incredibly disrespected. What he did not know was that my friend had actually texted me when she left, explaining that her son with special needs had been in an accident and she had to go to the hospital. It's interesting because I totally got the presenter's frustration--I've given lectures before and it can be awful when there are interruptions. But in this case, I saw her side as well and understood the fear and urgency of her situation. Once I relayed the story to him, I saw his heart soften and a connection take place. He told me that he and his wife were pregnant and that he would have done the same thing for their child.

So Plato was right--everyone is dealing with something that we know nothing about. What we are responsible for, however, is remembering to stay open to another person's story and to teaching them about ours, as opposed to living in a place of silent resentment. Years later, I think about what a less reactive, more centered me would now say to that coach: "Actually, I have diabetes and as a result of my medical condition, I had a low blood sugar and one of the symptoms besides feeling terrible is hunger. Let me know if you have any other questions." There is a difference between shaming someone and educating them--and the message tends to be better received when you are coming from the latter. No matter how obvious it may be to me, he didn't know I would feel hurt, and it is my job to explain to him why because I'd want someone to do the same. 

 

Why can't you learn from your near-death experience?!

Many parents wonder why a child's life-threatening encounter with ketoacidosis would not be enough to scare them into taking better care of themselves and "appreciating the severity" of their disease. 

A very dear friend of mine had a heart attack two years ago. It shook her and scared her to the core, and yet she said she was grateful for the experience because it made her realize how precious life was. As a result of this wake-up call, her diet and lifestyle completely changed. She cut way down on foods high in salt and fat, and began exercising. The fear of losing her life was fresh. But after six months or so, old habits came clawing back. As human beings, we cannot live in fear for long periods of time. The fight-or-flight response did an excellent job of keeping us alive back when lions regularly jumped out of bushes and tried to eat us, but studies (and real life experience) show that extended lengths of time living with fear-induced stress can lead to a whole slew of physical and emotional issues, from poor sleep and exhaustion to difficulty concentrating, anxiety, depression (and, for those of us with T1D, elevated blood sugars as a result of the release of sugar which we produce to be ready for fighting and/or “flighting”). So in the short term, fear can serve as a motivator, but it does come with a cost and it doesn’t last forever. As Gandhi said, "what is gained through fear lasts only while the fear lasts".

Stay tuned for part II next week on why adolescents struggle to learn from mistakes!

 

 

Miracles

What is a miracle? People wish, pray, ask for them all the time. It sounds like something that happens to you, that you really don’t have any control over. It’s like you’re at the mercy of something or someone else and that there’s no real way to be active in the process. I bring this up because most of us with a chronic illness do not wish to have one and often wish for a miracle--that we might feel better or be healed. I recently read miracles defined in way I had never heard before. Marianne Williamson talks about miracles as a shift in perception from fear to love. What does this mean in terms of a chronic illness? For me, this means seeing my diabetes in a completely new and radical way. Instead of something that is tiring me out, beating me down and, more or less, trying to kill me (all fear-based ideas), I had to re-examine my relationship with my diabetes. This was not easy. At all. And if you ask me, this is a miracle. With everything that diabetes entails (the attention, thanklessness, and no vacations allotted), you better believe that shifting my perspective was a ridiculous miracle. In order for me to figure our this new perspective, I actually had to draw this relationship between me and my diabetes, and do you know what? Much to my surprise, diabetes wasn't a huge monster with teeth eating cookies and screaming at everyone ("Eat all the things!"). It was before, for sure, but I've done a lot of work on this and I eventually figured out that perspective was draining and not at all helpful (because let's be honest--who wants a testy, ravenous behemoth around?). When I draw it now, diabetes is a little girl who needs me to care for her. She is small and scared at times, and she needs me to love her. Whether this idea is "accurate" or not is irrelevant. The part that counts is that when I think of my diabetes as the little girl, I want to take care of her, and my behavior shifts accordingly, as opposed to the evil monster idea. This shift is a miracle, and it had nothing to do with what is outside of me. In fact, no one could do this but me. I decided that my previous notion of diabetes was not serving me so I took control of it and changed it. Chronic illness can be overwhelming, particularly when depression and anxiety are involved, and sometimes we need support. I help people rediscover hope and if you find yourself struggling, I encourage you to reach out.