Out of the Shadows, Part 5 | Navigating the divide: Youth, older adults face similar issues, but generational differences can impact how they deal with mental health
Right before COVID-19 hit in March 2020, Margaret Redfern knew she was struggling. The now 17-year-old Steamboat Springs High School student was finishing up her sophomore year, and she just didn’t feel like herself.
She was dealing with a lot of anxiety and some feelings of depression, and she was lashing out at her family, which made her even more upset.
“It was double layered — anger and sadness,” Redfern said. “I’m feeling awful, but I’m also being awful to the people that I really love. And so that really set it off for me. I was, like, ‘OK, this needs to be dealt with.’”
She responded by going to see a therapist — something she thinks is important to talk about with others who might also be struggling with mental health issues.
“I definitely think the hardest part is seeking help,” Redfern said. “That’s like the hump to get over in solving mental health issues.
“For anybody who’s struggling, there are people there to help you,” she said. “People want to help you, and you’re not alone.”
Taking the first step and beginning therapy wasn’t easy for Redfern.
“Therapy is kind of like you open up a wound, and you feel all the things you’ve been trying not to feel for so long. It’s difficult, but you really have to stick it out.”
She said she’s in a much better place now.
“Therapy definitely helped me feel more stable,” Redfern said. “It helped me understand what I was feeling and gave me the tools to cope with it.
“I don’t ever want to go back to where I was. It was so draining to be in a bad mental health place, and once you know how to deal with it, I feel like you try to make an effort to not feel that way again, and therapy is part of that.”
Jo Poole, a resident of the Doak Walker House at the Casey’s Pond senior living community in Steamboat Springs, also believes in the power of therapy.
The isolation caused by COVID-19 protocols, which left her alone and without visitors for much of the past year, was something she handled surprisingly well. From an early age, Poole said she often found herself alone in her childhood home in Washington, D.C. Her mother worked and also suffered from paranoid schizophrenia and alcoholism and, at times, had a hard time caring for her daughter.
“I was an only child, and my mother and father divorced when I was in third grade,” Poole said. “So my mother had to work and that meant when I came home from school, I was alone. I learned to keep myself busy, usually playing the piano or drawing, so I guess you could say I got used to being alone.”
After her own children were grown, Poole said she began feeling depressed, sought counseling and was prescribed anti-depressants.
“I’ve often sought therapy, so that as I speak, I can get feedback,” Poole said. “The feedback I get is a lot clearer returning to me than what I am saying or thinking.”
Now at age 84, Poole continues to seek counseling and visits with a therapist once per week. She also writes a daily blog, which she said is composed of personal essays, and she often turns to art as a way of expressing her emotions.
“I bought a big art pad, and when I get really frustrated, I’ll just open to a new page, and with my art brushes, I’ll get out the dark colors and create a landscape that’s dark with darker trees. And on good days, the pastels will come out.”
Redfern and Poole are representatives of Routt County’s most vulnerable populations — our youth and our aging population.
These two groups, divided by decades of life experiences and generational differences, find themselves dealing with some of the same issues — depression, anxiety and feelings of isolation triggered by COVID-19 — but how they characterize and address those issues can differ greatly.
‘We don’t know how to be old’
Katie Keller, social services coordinator at Casey’s Pond, has two words to describe the way older adults often approach mental health issues. She calls it “generational acceptance.“
For many in the 70 and older demographic, mental health was not something openly discussed while they were growing up, and the people who did get help were often institutionalized.
“So somebody who has low-grade depression or is moody or who just doesn’t feel good isn’t going to identify that as a mental health issue,” Keller said. “They don’t see that it’s a spectrum, and they don’t understand they can have depression and still be a functioning adult and not have to be hospitalized.”
Among the residents of Casey’s Pond, Keller said she sees older adults struggling the most with depression and anxiety. They also are often experiencing grief and the loss of their independence.
“Most people who are aging, and particularly those that move to skilled communities, have had an enormous amount of loss in their life, so I would say that is where the depression is coming from — it’s not always diagnosed depression,” Keller said.
She also pointed out that many residents thrive in a senior living setting, especially communities like Casey’s Pond that practice the Eden Alternative, a philosophy of care dedicated to enhancing the quality of life for elders and their caregivers by eliminating what is referred to as the three plagues of aging — loneliness, helplessness and boredom.
“Aging also has its benefits,” Keller said. “It’s a time of reflection. It’s a time to identify your legacy.”
A large part of Keller’s job at Casey’s Pond involves advocating for the residents, and in that role, she said she has seen a rise in mental health struggles since COVID-19 arrived. She conducts a depression screening on each resident every three months, and since the start of the pandemic, Keller said the scores have gone up.
One resident told Keller COVID-19 had taken away her voice and the voices of other residents. The woman called it “learned helplessness.”
“They weren’t given a voice in what the state was telling them, and us, to do, and so it just felt like it took away that independence and independent thinking,” Keller said. “They had no control of their life. They were told what to do; they were disconnected from their families.”
The unpredictability of the situation was hard on residents. Keller compared the experience to a slingshot with rules constantly changing.
“We have come so far, but at one point, we were so shut down that no family was coming in unless somebody was end of life,” Keller said. “They had to stay in their rooms, and staff had to wear PPE going in and out of their rooms. That was hard.”
Carla Portigal, who worked for Mind Springs Health in Steamboat Springs for 40 years and now has a private counseling practice, is 73. She has lived through many of the changes her clients are experiencing as they age. She knows getting old isn’t easy, and she said people aren’t taught how to navigate this chapter of life.
“One of the hardest things about aging is that there is so much loss and change, and with that comes depression, and depression is probably one of the most prevalent things we see,” Portigal said. “These are people whose lives have been very often independent, and now, they are not.
“And certainly COVID has accentuated that isolation and depression,” Portigal added.
Another dimension of modern life that contributes to the mental health challenges of aging is technology, and during COVID, older adults were particularly dependent on Zoom calls, FaceTime and email to stay connected to their loved ones during the forced isolation.
“People my age and older are not really versed in accessing technology,” Portigal said. “And this remote world we have created has really closed off some seniors, who are not technologically advanced.”
Portigal believes aging in the American culture is difficult, and older adults often lose a sense of purpose as they age.
“We have such a clear identity through our 50s when we’re still working on our careers and our families,” Portigal said. “And then you lose your family, you lose your career, you lose a lot of your friends, you lose your physical ability. It’s frightening, and we don’t have a great system for teaching people how to do this stage of life. … We don’t know how to be old.”
And though older adults can have a harder time asking for help because they grew up in a generation that didn’t often talk about mental health, Portigal knows seniors can benefit from therapy.
“The more depressed we get, the more isolated we get, and when we’re dealing with illnesses and things like COVID, it’s one reason after another to just pull back,” Portigal said. “That’s not the best way to do any stage of life … talking through issues and being able to think about things differently, frame them differently, really can be very helpful.”
Learning the language of mental health
Susie Clark, who works for Mind Springs Health as an early childhood mental health specialist, spends a lot of her time in preschool classes providing assessment, consultation and intervention through early childhood mental health programs. She also does a lot of child and family therapy.
In her almost 30-year career, Clark said she’s seen an uptick in young children who struggle with significant anxiety and worry, and she’s noticing it even more due the pandemic.
“The families I see seem a little more stressed, but it’s not all just coming from increased busyness or craziness for our families,” Clark said. “I think that we’re more educated, and so we’re noticing these issues more.”
Clark is also involved in the prevention of children’s mental health issues through her work with early child care centers, preschools and home day care centers in Routt County as part of the state’s childhood mental health consultation program, which is free and voluntary for kids from birth to age 6.
“I can recognize a child that’s going to have some issues later, and it’s so wonderful to be in that preventative mode,” Clark said.
She works with children to help them learn how to identify and talk about what emotions they are feeling.
“There’s a lot of work on what does your body feel like when you’re really worried? Or when you’re really mad? How are we going to shrink up that feeling that just feels so big for you right now?” Clark said. “We learn coping skills together, and that is just a lovely thing. I work with a lot of parents who say, ‘I wish I’d learned that when I was 4.’”
Whitney Bakarich, who previously served as Mind Springs’ day treatment alternative program clinician and recently took on the role of youth resiliency program manager at Northwest Colorado Health, has spent the past seven years providing intensive mental health therapy programs for middle and high school students who are experiencing significant difficulty in many areas, including home, school and community.
In that role, Bakarich gained a deep understanding of the mental health issues facing Routt County youth.
“I would say trauma is a big one,” Bakarich said. “I think everybody has something traumatic that happens in their lives, right? We all experience death. That’s part of life. We all experience loss. We all experience pain, and we all experience stress. This is part of being human.
“I know we like to think of Steamboat as a little bubble, but real people live here,” she added. “And so whatever problems that people face, we have them here — divorce, grief, death, substance use, anxiety, depression.”
Bakarich said she believes conversations about mental health are more normalized among younger generations. When she walks into school buildings at the start of the day, she loves to hear kids talking about their feelings.
“They say, ‘Boy, I’m really anxious about this test today,’ or they say, ‘I’m having a lot of anxiety around this,’” Bakarich said. “They’re using these words appropriately, and that’s cool.”
She said the schools have done a great job of embracing socio-emotional learning.
“It starts with the little kids and giving them the language around mindfulness,” Bakarich said.
Both Clark and Bakarich spoke about the increased mental health resources available through Routt County schools, but they said access to mental health care for youth and their families can be restricted by a shortage of providers, especially those that accept Medicaid.
“The barriers of lack of funding and lack of resources is more at a larger systematic level,” Bakarich said. “Mental health is physical health, and it’s like people forgot our brain lives in our body. Policymakers continue to make a distinction between physical and mental health, and we need to make sure that we include mental health in health care reform, because whatever health care disparities face rural communities, amplify that by 10 for mental health.”
Mental health issues among children and youth of Routt County also have been exacerbated by the pandemic, Bakarich said. In the past year, she has been working at 150% to 300% of her normal capacity.
“We only have 12 kids and their families on our caseload at any given time, so it’s the frequency of contacts that has increased,” she said. “People’s capacity to deal with the stressors in their lives are just lower (due to COVID), and something that people may have been able to figure out, they just don’t have the energy to do that now.”
As a 14-year-old student, Ford Fontaine has experienced first-hand the changes brought on by COVID-19. He said the pandemic intensified the pressure he and his friends sometimes experience as teens living in Steamboat Springs. He said doing school completely online was difficult, and then when students returned to class in hybrid models, there was the unpredictability of quarantines due to positive COVID-19 tests among students.
“I got quarantined three times, and it was hard for me, because I’m not the type of person who does really well working by themselves,” Ford said. “It just made me feel really stressed.”
He said he and his friends also struggled because they weren’t able to get together and do the things they love — like ski and hang out.
The teen said it’s important to ask for help if you’re feeling depressed or sad.
“If you’re feeling bad or not having the greatest day, reach out for help or tell your parents or a counselor or REPS, because things can get out of hand,” Ford said.
Focus groups offer differing perspectives
For this installment of the series, Steamboat Pilot & Today conducted two focus groups — one with six 14- to 17 year-olds and another with six 72- to 90-year-olds. The participants wanted to remain anonymous but were very open to discussing the mental health issues they and their peers were facing.
The older adults were a group who exercised regularly together at the senior center in Steamboat Springs and recently, returned to in-person classes following a COVID-19 shutdown of activities. They all still drive and enjoy a comradery that pre-pandemic involved going to movies together and volunteering.
The teens were members of the Routt County Teen Council and more loosely associated through shared participation in the organization that is dedicated to ensuring youth have a voice in social, political and environmental issues. Participants included students from Steamboat Springs High School and Steamboat Mountain School.
One of the older adults in her mid-80s spoke about how physical health impacts mental health, especially as one ages. She said she had two strokes in November, which kept her from being active and doing the things that keep her mentally stimulated while she was recovering.
“There was pain, stress, anxiety and loneliness,” she said. “When you are injured or dealing with something that keeps you from being with this group, that’s when there are real feelings of isolation. When I was in the hospital, I’d dream about when I could get back here.”
The oldest in the group said keeping physically active is what helps her retain a strong mind, body and spirit, and the others agreed.
During COVID-19, when in-person activities were not available, members of the group said they kept mentally active by playing games on the computer, doing jigsaw puzzles and reading. They also said they tried to get outside and walk whenever they could and stayed in touch using a group email.
Members of the group also talked about the grief they experience when friends and spouses die, and how much it helps to have family close by to help with grocery shopping or transportation to doctor’s appointments.
Although COVID-19 had a big impact, it was not the first pandemic or hardship the older adults had lived through. They listed polio, World War II, The Great Depression and AIDS as global issues they have faced over the years.
They admitted they probably don’t talk about mental health or seek help as openly as their younger counterparts.
“Children are raised differently now,” one woman said. “They all wear princess dresses and crowns. It’s a different time. In our time, you just had to learn how to deal with your life. COVID may seem like the worst thing, but we had to live through many decades of the worst thing. It’s a matter of perspective.”
“I’d say we have a more ‘can do’ attitude than younger generations, and so we handle (mental health) issues differently,” another woman added.
The teen focus group listed anxiety, depression, eating disorders, body dysmorphia and the almost crippling pressure they feel to be the best in school and sports as some of the mental health issues their generation faces.
“There’s sometimes pressure to like look a certain way or act a certain way,” one Steamboat Springs High School senior said.
“There are just certain expectations, and I think school contributes to it,” added another girl who will be an incoming high school freshman in the fall. “They say if you’re gifted in elementary school, by high school, you’re just gonna be depressed — everybody expects them to be super-duper good, and at some point, they couldn’t do what was expected of them, and it just sort of breaks them.”
The teens also discussed their propensity, sometimes influenced by social media, to compare themselves to others, which they agreed was not good for their mental health.
“Maybe somebody seems perfect on the outside, but you don’t know what they’re feeling,” said a girl who will be a senior at Steamboat Mountain School. “They might be super anxious or depressed or have body image issues, but you don’t know that because you just see them doing well on a test or in a race. People don’t always understand what’s going on in someone’s personal life, and sometimes, I find myself projecting what I don’t feel like I have onto other people I don’t really know.”
“We need to realize that we all pretty much have the same issues,” added another Steamboat Mountain School student. “We all struggle at some point or another with the same things, and we can help each other.”
Another teen discussed what it was like to get into a depressive state and struggle with telling others about what she was feeling because she lives in Steamboat.
“It’s hard to say I really don’t feel good, because it’s like you’re not grateful or something or you’re not enjoying the beauty around you,” she said. “But I can be sad and grateful at the same time and still like where I live.”
Several of the students also talked about the stresses of the past year and the period of history they were growing up in — with a pandemic, online-only school, racial justice protests, rioting and thousands of people dying from COVID-19 daily.
“It’s like we’re coming of age during such a weird time,” one of the older teens said. “And since we were stuck at home, all of these things were bearing down on us, and there was nothing else to think about. It was just a lot coming at us all at once, and it was hard.”
“I think it’s a contributor to why we’re often seen as a really depressed generation,” another young woman added. “It’s like a loss of innocence.”
The importance of staying connected
As executive director of the Routt County Council on Aging, April Sigmon spends a lot of her time with older adults, many of whom are still living at home, often alone, but who find connection through the programs Sigmon oversees at senior centers in Steamboat Springs, Oak Creek and Hayden.
She said some of the issues she sees older adults dealing with are related to loss of independence, which includes the deterioration of vision and hearing, as well as isolation and loneliness that often lead to depression and symptoms of dementia.
“Particularly, for us, it’s the loss of a spouse that often brings a client to us,” Sigmon said. “A lot of our clients are widows or widowers, and they start getting involved with our programs once they don’t have that person.”
The activities offered through the Council on Aging — such as exercise classes, communal meals, bridge club and group outings — are designed to build community and keep older adults stimulated, healthy and active.
“We want to give people those peer connections so they can relate to somebody that’s experiencing the same thing they are,” Sigmon said.
For example, Sigmon said there is a group of men who gather at the Steamboat Springs Community Center, where the senior center is housed, almost every morning. They call themselves the Grey Gourmets, and they drink coffee, do crossword puzzles and just “chit chat,” Sigmon said.
When COVID-19 hit the community, all activities offered by the area senior centers, except for the home-delivered meals program, came to a halt, and Sigmon said this greatly impacted her clients.
“The isolation and not being stimulated mentally has had an unbelievable effect on the onset of different dementias,” Sigmon said. “And now that we’re opening back up, and I’m seeing clients in person, the amount they have aged in one year, compared to the previous five years, is heartbreaking.”
To combat some of the loneliness of COVID-19, a pen pal program was initiated that paired area senior citizens with an elementary school classroom. Letters were distributed when home meals were delivered. The pairs were asked to correspond once per month, but Sigmon said it quickly turned into weekly communication.
“The kids and the adults were so quick to write back to each other,” Sigmon said. “They were exchanging stickers and photos. And with school coming to an end, a lot of them asked about getting their pen pal’s address and continuing the relationship.
“I think it was a really fun project that came out of the pandemic and kept the generations connected,” Sigmon added.
And now that area senior centers have returned to in-person activities, Sigmon is already seeing a positive change among her clients.
“I am seeing so much excitement and seeing how much being together again boosts their spirits,” Sigmon said. “And even my clients who may have been a little grumpy in the past have really come out of their shell.”
Northwest Colorado Health also offers an Aging Well program to help older adults lead healthier and happier lives. Activities, like exercise classes, an aging mastery program and senior wellness clinics, are available in Hayden, Steamboat Springs, South Routt County and Craig and aimed at reducing the risk of falls, injuries and illness and preventing social isolation.
School district intensifies approach to mental health
In May, the Steamboat Springs School District was awarded a five-year, $500,000 grant from the Colorado Department of Public Health and Environment that will allow the district to hire a full-time behavioral health coordinator to oversee all counseling and mental health services offered by the district. Shelby Dewolfe was hired in that role last month.
The position is an integral part of the district’s goal of more effectively coordinating the increasing number of mental health services offered. District officials say the expansion of mental health services is due, in part, to grants the district has received from various community organizations, including the Craig Scheckman Family Foundation and UCHealth Yampa Valley Medical Center Foundation.
Dewolfe has worked as a counselor in the Steamboat district for 13 years — one year at the high school and then 12 years working with kindergarten through fifth-grade students at Soda Creek Elementary School.
When asked about some of the most prevalent mental health issues local children and youth face, Dewolfe said anxiety is common, and it is something experienced by students from kindergarten through 12th grade. She said there is also a lot of substance use and abuse.
“Whether that’s students using or their families actively using and having the consequences of substance abuse within the family component,” Dewolfe said.
Suicidal ideation and components of depression are other issues Dewolfe sees.
“I was actually shocked at how young some of the kids are who have considered that or start wondering about suicide and wondering if that’s a solution,” she said.
In her new role with the district, she will be working to establish systems to maintain and sustain the mental health services the district offers — collecting data, establishing best practices and filling in service gaps. One of her priorities in the new school year will be implementing a universal social emotional screener to ensure kids aren’t falling through the cracks and missing out on needed mental health support and services.
“This will be a way to assess all kids,” Dewolfe said. “We want to uncover kids who are needing support but aren’t outwardly showing some of those things. It will help drive our services based on the true needs of all students.”
According to Dewolfe, the school district’s approach to mental health has drastically changed over the past five years.
“It’s become a priority,” she said. “I would say 15 years ago, when I first started in the district, every year counseling was kind of on the chopping block. I don’t feel that way now. I feel like everybody’s really recognized the importance of mental health and that we can’t have strong academic performance if we have significant mental health issues.”
Jay Hamric, Steamboat’s director of teaching and learning, said the district has made a strong investment in supporting student mental health.
“This has been something we’ve been very strategic and intentional about over the past couple of years,” Hamric said.
The district offers varied tiers of mental health support, and over the past five years, the number of school counselors has increased from 14 to 20. But Hamric said mental health is not something that is handled exclusively by the counseling staff.
“Our teachers, our bus drivers, our custodial staff have all been trained in these different mental health programs — trauma-informed care, restorative practices — because we realize, as soon as the kid gets on the bus and arrives at school and is in the lunch line, it takes this family of staff to provide that nurturing support for kids to feel safe, to feel comfortable, to feel loved.”
Hamric said brain research shows that learning capacity decreases significantly if a student’s emotions are not regulated, and students are taught, through the district’s Mind Up curriculum, about how the brain works and how stress, anxiety, conflict and trauma can interfere with learning.
“We have common language, and we talk about tools that you can use to regulate those emotions and understand, ‘I’m feeling tense, I’m feeling stressed, I’m feeling anxiety, what are some things I can do, which will calm me down, which will allow me to communicate better and, ultimately, let me learn better?’”
Despite all the efforts being made to spark conversation and action surrounding issues of mental health, Redfern, a rising senior at Steamboat Springs High School, still thinks it’s something that’s hard to talk about.
“Everybody has their own problems going on, and it does make you feel kind of insignificant,” she said. “I didn’t have any like trauma that I could point back to and say, ‘I’m feeling really sad about this.’ And I think that made it hard for me to talk to my friends and be like, ‘I’m doing poorly,’ when they might be doing worse than me.”
Still, Redfern is optimistic about the future.
“I feel like our generation has so many solutions, and so many bright ideas about how to make the world a better place,” Redfern said. “And I feel like it’s changing. I feel like maybe, compared to years past, people are listening to us more.”
To reach Lisa Schlichtman, call 970-871-4221, email lschlichtman@SteamboatPilot.com or follow her on Twitter @lschlichtman.
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