Episode 5: Understanding Mental Health in Young Adults with Bill Mulcahy

OT Ep. 5 Transcription.txt
00;00;09;01 – 00;00;52;01
Kelly Parbs
Welcome to OnTopic with Empathia. I’m your host, Kelly Parbs. I’m a licensed clinical social worker with over 35 years of working at empathic, supporting individuals and organizations across the globe. Today on the show, we’re talking about mental health in young adults. Our guest is Bill Mulcahy. He is a practicing licensed professional counselor, psychotherapist, and author with a focus on teaching people how to cope with the challenges of life in the 21st century. In Bill’s private practice, he has extensive experience in working with children and young adults. It’s great to meet with you today, Bill. How are you?

00;00;52;02 – 00;00;54;28
Bill Mulcahy
I’m doing really good, Kelly, thanks very much. Appreciate it.

00;00;55;05 – 00;01;00;18
Kelly Parbs
Bill, you and I worked together back in the day. How many years has it been now? How long ago was that?

00;01;00;23 – 00;01;04;08
Bill Mulcahy
Yeah, I don’t mean to age us, but I think it’s been 21 years, so.

00;01;04;14 – 00;01;47;11
Kelly Parbs
It’s been a while. And both of us have had a lot of experiences and have seen a lot of things since then. I’m really looking forward to our conversation today. This topic is relevant to so many people. Some of our listeners are young adults who may have challenges with their mental health, and many of us have young adults in our lives who we love and care about. We know that young adulthood can be a tricky time in life and determining whether certain feelings are normal or a symptom of a mental health condition can be difficult. So what are some of the common mental health issues that young adults may face and how can they be identified?

00;01;47;17 – 00;03;52;03
Bill Mulcahy
It’s a great question, but before I answer that, I just want to do one really quick thing. I just want to make sure we are all talking about the same thing when we talk about young adults, because some people have some ideas about, well, it’s 14 or 15 or 16. And what I’m talking about today is from 18 to 26. I see young adults as being that age group. I know some people may differ in that, but our young adults brains are still developing. Their brains can still be emotional. They have a heightened reward system. They’re more sensitive to peer pressure. I think that’s just something really important in the beginning to discuss. Now, as we jump into what are some of the common issues that we see in this age group one, anxiety, People that are struggling with worries and fears. Another is depression, the low mood, the feelings of worthlessness, the low self-esteem, another disorder that becomes prevalent during this time is bipolar disorder, as well as addiction. Those are the main four ones. I would like to just give a little bit more information on this. I think there’s two situations that are going on in the world, too, right now that can lead to some hopelessness in this group. I work with a lot of young adults, and two things that I’ve heard them worried about that are causing the sense of hopelessness, maybe even despair are the impact of climate change and then also the economic insecurities. Kids these days, or I should say young adults these days, just aren’t making as much money. There’s not the economics available to them. That was when, you know, you and I were their age. And so I’m seeing this growing sense of hopelessness and despair. So those are the main things that I see. I think there’s other things out there. I mean, things like schizophrenia show themselves during this age group. It’s not a high percentage of people, but we do see those kind of things pop up in the young adult age group.

00;03;52;09 – 00;04;52;25
Kelly Parbs
I can relate so much to what you’re saying. At Empathia, we are currently hearing from so many young adults and thank you, Bill, for really defining the age group that we’re talking about today. I think that’s very important. We’re talking with plenty of college age students or grad students. They may be having trouble with their mental health, having to even step away from their studies because they can’t keep up. And like you said, they have so many other things on their mind. They’re dealing with relationship pressures, financial pressures, and who knows what else. And then there’s social media. Young adults are growing up in a world where social media has now been a part of their lives, their whole lives. It’s how they connect with people, especially with friends. We know, you know, from an emotional standpoint that there are both positives and negatives to this constant connection. Can you address how technology and social media impact the mental health of young adults?

00;04;53;02 – 00;06;38;10
Bill Mulcahy
I think you make an excellent point. For you and I, growing up, this was a choice. This was we lived at a different time period when there was no social media. When technology was, you know, maybe a computer. And now, you know, we have computers in our hands and telephones in our hands and instant access to things all across the world. So it’s a constant for young adults. It also is part of what defines their reality. One of the concerns that come up for me is that because it’s a reality that you’re seeing on, you know, on a screen, there’s a lot of miscommunication. There’s a lot of lost, you know, information within the communication realm of it. This leads to a lot of rumors, unrealistic views of other people’s lives, and also, of course, peer pressures and bullying. That becomes a still an issue during this time frame. On the other hand, of course, this platform is how people receive information and educating people, especially about issues like mental health is being done in ways that we’ve never seen before through social media and technology. So in that regard, it can be, you know, helpful. One of the things that I still worry about, though, is these items can be a distraction for people. They can be used as a way to numb out. They can disturb sleep and other routines. We know those kind of things are happening. So I think the correct word to use with these devices and use is the word balance, it’s just like everything else in life. People and young adults need to have a balance of using social media and technology as well as having other experiences face to face, person to person.

00;06;38;12 – 00;07;18;07
Kelly Parbs
You know, Bill, I worry about young adults who are not having enough of that actual personal interactions with other people. We know that people who spend more time on social media and less time in actual personal interactions have an increased risk of feeling anxious or depressed. At Empathia, we work with many young adults who are maybe already having anxiety before, but then the pandemic brought that anxiety to the next level. How has COVID impacted young adults, and what are some of the potential long term effects?

00;07;18;14 – 00;10;30;20
Bill Mulcahy
Yeah, that’s a great question. And again, I think one of the keywords you said there is potential long term effects. I don’t think we’re going to know what the effects of this COVID thing have been for a long time, and that’s kind of scary. Especially on a group like this. But much like, you know, most of us experienced, this group became, you know, very isolated during the COVID pandemic. And if you think about this group and what does this group really rely on? It’s socialization. I mean, their brains are designed for socialization. And you think about COVID and all that it did and all that it shut down. And then just think for a second where do young adults go for entertainment? And, you know, just to enjoy themselves? They go to bars, they go to coffee shops, they go to exercise places. You know, they go to work, maybe they go to parks and all those were closed. I don’t think we can really start to understand the dynamics that that had on them. Although an increase of mental health seems unfortunately a realistic and logical thing that you would experience from that. The latest study that I could find was from University of California, S.F., which I think is San Francisco. 48% of people of this age group have struggled with mental health issues. Kelly, that’s half. That’s- that’s some alarming numbers. Yes. And that’s significant. But again, this group is a very resilient group. Their brains are still developing, which allows them to grow in ways that are unexpected. But again, when you have these kind of pressures on you and they’re ongoing, it’s really difficult, like something like COVID, you know, And I want to just say one other thing, too. A lot of the people that I work with are in this age group, and I saw them really struggle in COVID. And a lot of the times, too, it was because they were living alone and there were the pressures of living alone and the constant of living alone. And then there was another group that were living with their parents again, and this was just as disturbing to them. You know, here I am, a 25 year old adult, and suddenly I have to go home and live with mom and dad. I’m under their rules again, and yet I’m an adult. I live on my own. I’m working from home. I’m living from home. Everything is from home. You can imagine if the home is not a functional place, how difficult that could be. And then one other thing that kind of strikes me about this group that I just would like to remind everyone about, I sometimes think we forget about the pressures of trauma in past trauma, you think about this age group from 18 to 25 and maybe not the 18 year old so much as, but the 20 to 25 year old group. This group was four and five years old when we experienced 911. And so now it’s 20 years later and we’re a part of a society again where fear is an everyday thing. Things seem out of control and of course the adults around them can’t fix it. I just worry that those ongoing kind of trauma things will cause significant mental health issues down the road for people, including, you know, medical issues as well, because we know those can be contributing factors as well to medical issues.

00;10;30;27 – 00;10;40;03
Kelly Parbs
You know, I wouldn’t have thought about the fact that 20 somethings were in kindergarten during 911. So their life has kind of been bookended by-

00;10;40;05 – 00;10;40;28
Bill Mulcahy
It has! It’s a-

00;10;40;29 – 00;10;41;27
Kelly Parbs
Little imbalance.

00;10;42;11 – 00;10;49;03
Bill Mulcahy
Yeah, it has been bookended by there’s no doubt about it. And I think we don’t sometimes understand that trauma.

00;10;49;10 – 00;11;24;28
Kelly Parbs
You know, when you were talking about maybe young professionals living at home with their parents and working from home, what came to mind for me is young professionals in the health care field and teachers who entered their fields in the midst of this pandemic. So many of them now are second guessing their career choices because of the chaos that they experienced upon entering their jobs. I heard of a nurse who said, you know, I didn’t sign up to be a hero. This is nothing like what I thought it would be.

00;11;25;03 – 00;11;43;01
Bill Mulcahy
And I think that’s in a lot of job areas. You’re exactly right. I think the same experience holds for people who graduated from high school that year and were supposed to go off to college and lost experiences. Yeah, it’s prevalent across this age group. I think that a lot of people struggled with that.

00;11;43;19 – 00;12;14;05
Kelly Parbs
I read an article recently about the grind culture, which is a term I hadn’t heard before, and it basically said that many young people feel guilty unless they are being productive and making progress towards future plans. It’s said that young adults often spend their time in the future rather than appreciating the present. Bill, can you talk further about what are the cultural pressures and expectations that fall on this age group?

00;12;14;13 – 00;14;09;15
Bill Mulcahy
The grind? I’ve never heard that term applied to this group, but it seems accurate. Think about this group for a second. Think about 18 to 26 year olds and just think about what they’re doing in their lives. First of all, as you’re 18, you know, there’s an expectation that’s put on you, right? That you’re supposed to leave home for college or at least go get a job that’s going to allow you to get your own place and move out. Is that happening? Well, it’s stopped because of COVID. And then we have economic realities that are making it more and more difficult for people to move out of their parents house. And then we have these pressures that the other young people who are going off to college are having to deal with. And what we see are so economic, social and academic pressures, right. That have just really coming to the surface and exploding at this point in young people’s lives. And just to talk about college for a second. College brings its own stress, right? You have academics. You have this increased responsibility. And what’s really ironic about it is you have an increased responsibility that coincides with, you know, a loosening of parental controls while you still have brain activity that can be somewhat loose and still emotional, sometimes chaotic. So that’s a struggle for young people as they’re trying to, you know, make the transitions, the loosening of parental controls and things. And, you know, this is why we see mental health issues rising, though, because a lot of these pressures, if you’re not prepared for them, can trigger the possible anxiety, depression, addiction and or a bipolar type of disorder. So, yeah, the grind is causing its own pressure and triggering possibly its own mental health issues.

00;14;09;26 – 00;14;40;03
Kelly Parbs
I just think that we as older adults, while we value and even expect a strong work ethic from young adults, we want to make sure that we don’t define them by their achievements, but let them know that they’re loved just for being who they are. The well-being of young people who are exploring or may be struggling with their identity or sexual identity is a pressing issue that we’re hearing more about. What impacts have you seen on these young adults?

00;14;40;10 – 00;16;26;11
Bill Mulcahy
I have to say I find this one of the most fascinating, interesting aspects about young adults in the world right now. I’m just going to be honest with you- 30 years ago when I was a young adult, yes, I am aging myself. This type of flexibility and acceptance, it just wasn’t present. And please don’t hear me saying that. I’m not saying there still isn’t bias and prejudice and acts of violence against people who have alternative identities. But this group has seemed to form its own conscious around sexuality and gender. And that said, the world, our society still has a way to go in supporting and fully supporting individuals that are LGBTQIA+. But these pressures, when you’re not accepted and you’re not appreciated, can lead to its own mental health issue. So think of it from this standpoint. Who you are in conflict with your own self about do I come out to the world? Do I show people who I really am? And you maybe have a world that isn’t just accepting as you need them to be. I mean, what does that do to a young adult? I know that it could be very conflictual and, you know, cause again, it trigger its own set of mental health issues, including depression, anxiety, things like bipolar disorder, suicidal ideation. So it’s really important that, you know, we have an understanding and an appreciation and an education of what these folks are going through and how we can support them. And I think a big part of that is we just need to listen to them. We need to listen and open up our minds and our hearts to what their experiences are.

00;16;26;23 – 00;16;57;12
Kelly Parbs
You know, one thing that hasn’t seemed to change since- since we were younger, Bill, is the importance of friendships. Friendships have always been such a huge, important part of adolescence and young adulthood. And that makes sense, right? That’s good, because as we grow up, we need to develop relationships outside of our families. How do peer relationships factor into the mental health of young adults?

00;16;57;20 – 00;18;53;21
Bill Mulcahy
So young adults and teenagers, by the way too, their brains are really hot wired for relationships. The brain is just primed for it. And so I forget the name of the author, but he calls it the second family developing. Right? So your primary family being your mom and dad, etc., etc.. You know, your siblings, the second family being your friends. And when we have a second family, we see good things and bad things. Right? And the influence of a second family can also be positive and negative. And so as we see young adults growing, you know, we see the impact of the primary family falling away and we see this second family growing and growing and growing and their impact growing. And just like anything in life, if you know you’re around people who aren’t healthy or you have ineffective coping or maladaptive coping that you’ve learned through these people, it can trigger mental health issues. On the other hand, you know, you hear many cases where, you know, you have young adults who are in families that aren’t so healthy and they’re being rescued and saved and listened to by their friends, their peer group. So this is just an important age for them also to be learning about relationships and social intelligence and emotional intelligence. And this becomes just one of those things where peers are not just kind of the balancing factor, but also the learning factor. It’s a double plus. But if people you’re hanging around with and or are maladapt, it’s a double negative, too. So it’s again, hopefully keeping a really good perspective in your life and hopefully having some good mentors that you can check in with a lot to make sure you’re staying on the right path.

00;18;54;04 – 00;19;21;11
Kelly Parbs
So as parents, one thing we can do is help our adolescents and young adults develop the skills of being a good friend and choosing friends who are healthy in their lives and help them develop that critical network while still letting them know that their family is always here for them, even when it seems like we’re their second choice.

00;19;21;20 – 00;19;25;05
Bill Mulcahy
Yeah, I think that’s an excellent way of saying it for sure.

00;19;25;13 – 00;20;14;16
Kelly Parbs
The transition from adolescence to adulthood, that’s a huge one. It’s challenging even under the best of circumstances and going from being dependent to then having to figure out the responsibilities of adulthood. Bill, Can you address how does the transition from adolescence to young adulthood impact mental health? And before you answer that, I want to mention that at Empathia, we have had so many parents reach out to us with concerns about their young adults who are having a hard time launching. You know, you mentioned those young adults who are still living at home, even though that wouldn’t be their first choice, maybe because of COVID, they’re leaving the nest earlier. Can you give us some insight into what is going on?

00;20;15;16 – 00;23;04;06
Bill Mulcahy
Sure. First of all, I want to address the whole idea of transition, because I think this is really, really, really important. And I don’t think we always appreciate this. So I think transitions are happening in our lives all the time and we don’t really realize it. Even, you know, transitioning from middle school to high school and then high school to either college or working in adulthood, somebody who goes from one job to another job, somebody who retires. These are all transitions, and transitions all have two things in common. They all have a loss and they all have a potential gain. And we’re constantly working through those two things of loss and gain as we’re trying to figure out these transitions. And often we don’t really admit this to ourselves, right? So there’s the eighth grader who’s going off to high school and is really excited about it, but he’s going to really miss his eighth grade social studies teacher because he was super cool and supported him and made him feel, you know, like he was really somebody, right? So the loss and then also the gain. Okay. So this group, though, moving from adolescence to young adults is a really tricky age, right? Because there’s this transition going. There’s this loss perhaps of safety, of security. Right. Of going to high school that’s familiar. You know, you’re under the eyes of think about the people that are watching you when you’re in high school. You have coaches, you have teachers, you have parents. You might have religious people watching you right there. Structures, there’s routines. And you have this push from adolescents moving to adults that they’re pushing for independence. Those are tough things to navigate, right? As young adults gain freedom and personal responsibility and independence. Right. They also have to create their own routines and structure. This is tough work for anybody. But if you’re not properly prepared and not properly in balance or perhaps, you know, using maladaptive coping, it’s a really difficult thing. I’ve seen a lot of people in my practice in this age group that I think right at this present moment I have five people that I’m seeing that are either high school seniors or freshmen in college, and you just get an appreciation for the pressures that they’re going through and all the time that it seems that they have to use to figure things out and get a structure. And it’s great to see them succeeding. But it can really trigger, again, mental health issues such as anxiety and depression. It’s an interesting time. It’s a time for great growth. It’s a time for great opportunities. But it also has the danger of mental health issues that come with it.

00;23;04;16 – 00;23;31;11
Kelly Parbs
I love the way you presented that idea that transitions are both loss and gain, and I think we as older adults have the opportunity to acknowledge that. And and help ease what young adults are going through by acknowledging, hey, what you’re going through. This is real. You are experiencing a loss. But then to highlight that there’s positives and gains that can come from that transition as well.

00;23;31;23 – 00;24;08;29
Bill Mulcahy
You know, let me give you another example, because I think it’s so important thing when you move from one house to another. I tell my clients, you know, make sure you go into every room and celebrate every room and what happened in your room and stuff like that. And the same thing happens for people when they go off to school. They’re no longer the same person that was in that room that did those things. That was, you know, they’re a young adult now. They’re going to see the world differently. And so it’s really good to help, you know, sort of say goodbye to those kind of things, but also then embrace what’s coming up. So I think it’s an important thing. We miss a lot.

00;24;09;13 – 00;24;36;15
Kelly Parbs
Great advice. I love that idea of taking the time and making the space to just appreciate what you’re leaving, you know, might be a little bit sad, but there’s also good things ahead and just make space for all of that. Bill I want to make sure that our listeners leave with some practical tips. What are some strategies for promoting mental health and well-being in young adults?

00;24;36;28 – 00;27;35;01
Bill Mulcahy
Educate, educate, educate. All right. We have this wonderful thing that’s called social media, so let’s use it to our advantage. Let’s make sure there’s platforms for young adults so that they know about the warning signs, so they know where to get help. So they can actually get help through things like apps and other things that can help people. But I think the first thing is to educate people in regards to mental health and well-being. That’s always first. And when we’re educating, I always think we need to take a really holistic approach with it, right? And I think this is really important. And a lot of people in this age group miss these kind of things. Mental health and wellbeing is really about four components. It’s not just about mental. It’s really about physical health and mental health and emotional health and spiritual health. And under the emotional health thing is obviously social as well. You know, and I think it’s really important that we educate people that all these components make up who you are and they all contribute to, quote unquote. What would be your mental health and well-being. So that’s another thing that I think is really, really important in the educational process. Another thing that I think is really important is being proactive. You know, this goes maybe a little before people actually are turning young adults. But I think we have a real opportunity through schooling and programs and books to really educate people about what are healthy relationships, how do we increase people’s social emotional intelligence? What are healthy cultures? You know, if I can get this down when I’m a high school student and I can go off to college all the more better to me, you know, if I have an awareness of myself and others, if I know what is going to help me with self-regulation before I go off to college, I’m going to be much more successful. Also, it would be really nice if we had some sort of screening process for people that are struggling in high school. I know that that might be, you know, something that some people don’t want to do because you can’t screen everybody. If we’re talking about 50% of the population of young adults having a mental health issue. It certainly would be nice if we had some sort of screening tool that would identify for people who are at high risk. Another thing is that we have to be able to get to these people, get to the young adults. We need to be creative. We need to have peer to peer programs. We need to take into consideration the cultural differences and economic differences that people have and be able to provide programs in all areas of the world. Right. I’m talking about the rural parts of America as well as in the inner cities. Again, being multicultural, friendly, if we’re not taking into consideration the diverse population and their unique needs, we’re really not being successful in helping this group.

00;27;35;20 – 00;28;18;07
Kelly Parbs
I could really hear the energy and the passion in your voice, Bill, when you talk about these practical tips and strategies, I can just hear in your heart that you want to get this information out to the people who need it. I really appreciate that. One of the things that you mentioned is being proactive. You know, I know that some young adults, they feel guilty or blame themselves for what they’re experiencing, or maybe they think mental health concerns are something that should be dealt with in in private. But I think part of being proactive is being able to create a safe environment for them to be able to talk about their mental health. Can you give us some ways that that we can do that?

00;28;18;20 – 00;30;15;21
Bill Mulcahy
So in order to build a safe and supportive environment, you know, just for a minute, think about yourself and you know what helps you to feel safe and supportive. You know, if you start there, if you always start there with being empathetic, what what feels good for me, I think that’s a really good starting point. But if you want to get more specific, you know, what we’re trying to do is build solid in respect of mutual respect in relationships, right? In order to work with people or communicate with them. We have to have a respectful relationship. And this group in particular is looking for that is think about when, you know, we were that age, what was important to us in the whole justice and righteousness of things. And it’s even more so nowadays, right? People, these age groups are going to recognize right away if we’re not respectful, we don’t want to build solid relationships and think we’re just being dis authentic. And in regards to that, we need to follow really good active listening skills and we need to be able to do it without judgment. That’s really essential here, especially when you take into consideration multicultural differences and economic differences. We need to educate ourselves, meaning other age groups and other folks involved with young adults. We need to educate ourselves about the developmental factors that are driving this age group, the brain development differences. We need to make sure we don’t talk down or dismiss them. Mainly, we just need to be available for them, you know, when we’re available for them again, we’re going to be listening. We’re going to be asking about their friends, we’re going to be asking about their interests. And again, we’re going to be aware of the cultural and economic differences, and we better be able to adapt because this is a very adaptive group of people. Their brains are adapting to things in the world. And so we need to be flexible, adaptable and, you know, stable in our abilities to help them out.

00;30;16;17 – 00;31;03;28
Kelly Parbs
Bill, thank you again for joining us today. We covered a really important topic, and regardless of whether your own children are young adults or you work with young adults or you simply just have young adults in your life, this information is very valuable. Thank you so much for your time. This episode is part one. Come back next time for part two. To hear that episode and other episodes of OnTopic with Empathia, visit our website, empathia.com. Follow us on social media at Empathia, and subscribe to OnTopic with Empathia to hear new episodes as they go live. I’m Kelly Parbs. Thanks for listening to OnTopic with Empathia.