WELHAVEN: There is help out there if you can figure out that you need help and are OK with asking for it.

NARRATOR: In this episode, Kristi, a senior benefits analyst in Human Resources and Val, a medical administrative assistant in Orthopedics, discuss their journey with mental health.

KLEINHANS: Before I started working at Mayo, I kind of already got the Mayo experience because I ended up at Generose about two summers ago. I was having a really hard time at my last job, and with office politics. I was having a hard time trying to keep everybody happy in the office and do it with the least amount of stress possible. It just was not working. It came to a head when I got a performance review. It was sort of like you're on probation for lack of a better term. That scared me. So when I went home to my husband that night, I was upset about it. I wanted to take my life, but he stopped that. A week later, I still was having anxiety attacks before going to work. That's what led me to Mayo Clinic Hospital ― Rochester and the two-week outpatient program at Generose.

WELHAVEN: What were you diagnosed with?

KLEINHANS: General anxiety and depression. I didn't know that I was depressed until I took the p9 PHQ-9 depression test questionnaire my primary care doctor gave me. I thought it was just anxiety because I had been dealing with that forever. But now there's this whole depression element where you think nothing's going to get better. You don't know how to get yourself out of the situation. When you start seeing those questions and just feeling that pit in your stomach, you're like, "OK, this hit home and something else might be going on here, too." I had no idea.

WELHAVEN: I am a huge proponent of that PHQ-9 depression test questionnaire. Whenever I have someone close to me talking about how they're struggling, I Google it. I send it to them and say, "You need to take the screening." Because with that screening, you can recognize: "Oh my gosh, I am feeling hopeless. I am not enjoying anything. I am not in a good place." It's so easy to rationalize: "I'm having a hard time at work. We're going through a pandemic. I'm stressed." But in many cases, it really is something more than that. And people aren't able to recognize that in themselves.

KLEINHANS: No, not all the time. It definitely was not in my case. It's a physiological reaction, too. Every question that I answered while I went down that survey, the tears started welling up more and more. I was just like: "This is me. It has been me for the previous five years, and I have done nothing about it." And that's probably why it all just came to a head at that time because I had done nothing. A lot of that was anxiety and depression, looking back now. So that was probably consistent until I was 22, and I'm 31 now. I only got that help two years ago.

So it was definitely a wake-up call.

I worked in radio. It's a very hard industry — very cutthroat, very demanding, very on-call 24/7, very image-conscious. All of that makes the scene a hornet's nest — an abyss that you can kind of fall into — because there's so much going on.

WELHAVEN: My story is quite a bit different up until the end, where you talk about what you were experiencing because I totally mimic that. In hindsight, I can see signs of it back when I was 16, 18, 20. But the first time I asked for help was when I was pregnant for the first time 10 years ago.

We struggled to get pregnant with our first. Then when I finally was pregnant, I hated everything about it. It's not that I didn't want my baby. I just wanted to be done with the situation. I was sick. I was stressed. I was anxious. I was worried. I remember crying to a co-worker, and she said: "Kristi, you need to talk to your doctor about this. It sounds like you have depression." And I thought: "Well, there's no such thing as prepartum depression. There's only postpartum depression." She said, "No, you can be depressed while pregnant." I was like: "But this is supposed to be the happiest time of my life. I'm finally having a baby I've always wanted."

I ended up going to my doctor. She prescribed me antidepressants for the first time in my life — a very low dose — and that helped. I had my baby, and he had health issues that he struggled with. He was crying all the time, and, so, I sank deeper. Then they increased my medication, and I was good.

Then when I had my second child, I was overwhelmed again, feeling like a failure at everything and not doing well. So they increased my medication again.

I remember having a conversation with my primary care doctor. I said, "I want a third child, but I'm struggling. Every time I have a child, I have to increase my antidepressant medication. That doesn't make sense. I shouldn't be having more children, right? Obviously, I can't handle it." She said: "Kristi, we can help with that. That's not a reason to not have a child that you want. We'll get you what you need."

I had my third child, and I stayed at the highest dose. And everything was good for a while. It was managed. I didn't have episodes. I was functioning very well. Then, fast-forward to 2020 with the pandemic. My kids weren't able to go to school, so they were at home 100%. I was juggling a full-time job and distance learning with two elementary school kids.

KLEINHANS: I can't imagine.

WELHAVEN: But that's the thing. Everybody says that. Everybody says: "I don't know how you do it. I can't imagine. It must be so hard." I would tell myself: "We're all struggling. I'm no different than my co-workers."

I finally had to admit that it was different for me because I already had depression. You can't put a depressive person in a depressing situation and expect the outcome to be OK. Things got dark. I had no patience with my kids. I would yell at them and then go to my room. I just wanted to be alone. I didn't want anyone to be around me. I would have meltdowns where I'd cry in the bathroom, and all I would think about in that moment was I just want things to be different. I just can't do this anymore. I can't live in this situation another day. It was just hopeless, and devastating and dark. It's hard to find people to talk to about it because they'd say, "Well, just think positive."

KLEINHANS: Which is the worst thing you could say.

WELHAVEN: If I could think positive, trust me, I would. I don't like feeling this way. They'd say: "You need a different perspective. You need time for yourself." I take time for myself. I go to the gym every day.

Eventually, I went back to my doctor and started getting help again. What actually helped me the most was taking time off work, which is a very scary thing. I tried taking a day here or there, but it didn't really help. So I went on a medical leave of absence, which was very frightening. Thankfully, I have a manager who I think the world of and would do anything for my well-being. So she was fine.

But then your co-workers — when I started struggling, I started acting differently in a way that they probably noticed. I'm normally so happy, bubbly, outgoing, talkative and social. Those are all the ways people describe me. I stopped calling people on Skype to talk to them to catch up on the weekend. I kept chitchat very short. I made myself unavailable. I just shut down socially. There was one person I trusted. She said to me, "I'd rather have everything at work fall apart than have you fall apart." And, of course, I immediately started crying.

KLEINHANS: That's the kind of support you need. That's the kind of support anybody needs.

WELHAVEN: Right. That gave me the courage to say: "OK, I need help. I think I need to be off work and it's going to be OK." Even though it burdened her to have me gone, it was just that unquestioning support: We're here for you. We trust you. We're not judging you."

KLEINHANS: When another employee comes to you and says that they're struggling with their mental health, just listen. Just listen because there are so many people who won't even do that much. I have seen employees totally turn their mood around and their day around just because they were able to have someone listen to them.

WELHAVEN: One of my doctors told me this is just a very small blip in your long career at Mayo Clinic. You may not be at work for a couple of months, but how large is that compared to the 30 years of service that you're going to have at Mayo? You're going to flourish and come back from this and be stronger and better in your job.

KLEINHANS: That's a great way to look at it.

WELHAVEN: How did you recover?

KLEINHANS: I went to the Saint Marys Emergency Department because I had an anxiety attack about 10 minutes before I was supposed to go on air. A co-worker walked in on me crying, and he took me there. He is part of our local chapter of the National Alliance on Mental Illness. He knew what to do, and I was very grateful for that.

I did two weeks of the outpatient Mood Disorders program at Generose. We talked a lot about social rhythm therapy, which is essentially just keeping a schedule and sticking to it to maintain your focus throughout the day. We did a lot of mindfulness, which I found most helpful — just sitting there and letting things happen without a reaction. Just let it be and let your thoughts collect. I found that to be pretty helpful. It helps you kind of learn to tune other things out. We did yoga and other recreation. It was a mix of a bunch of treatments. They were handing it to us on a platter and saying, this is some of what we know works. Let's try it all and figure out what works for you.

The worst part of it was I was leaving that program and going right back into that same environment that put me there in the first place. I had to learn the hard way that until I changed that environment, I probably wouldn't be happy. Sometimes it is about changing your environment — changing who you're around, what you're around. That's something I learned the hard way. I didn't want to leave radio. I loved my job. But I couldn't ignore that the industry was just not what I thought it was.

WELHAVEN: I couldn't really get rid of my kids. And I didn't want to, right? It's not like I didn't love them and want them around me. But getting rid of work for, I think it was three weeks, allowed me to reset. They slowly started going back to school, which helped. I got started with some therapy, which helped put my thoughts into reality. My big thing is I think I'm a failure. I have perfectionism running through my veins. Any little mistake and I feel like, if my children didn't get on their Zoom call on time, then they were going to be high school dropouts. And it would be all my fault.

KLEINHANS: I can understand those anxious thoughts.

WELHAVEN: Totally irrational. So my therapist would question me, "Is that a true fact, Kristi?"

KLEINHANS: No. But we can feel it with everything else going on around us. That pressure is everywhere. It's hard.

WELHAVEN: I want people to know that they don't have to live in misery. I feel like I'm recovered now after a couple months. I've learned things that will help me if things get really bad again.

KLEINHANS: That's the best part. It is just knowing that you at least have the tools. I don't know that anxiety or depression is something that ever goes away. It's just managed. And if you've got those tools to manage it, I think you're better off.

WELHAVEN: I can easily recognize now when I'm thinking and living in a way that is not the way I want to. The way I react to stimuli and triggers is just way different. After I recovered back into a good place, I remember driving in the car with my kids and my daughter did something. I just started laughing. I thought, I don't remember the last time I laughed in the car with my kids. Every day before that, it seems like all I did was just want to cry in the car with my kids. Isn't this amazing? They are funny kids, and I should laugh.

KLEINHANS: I'm not a parent, so I'm curious to know from you: Did you find depression before them any different?

WELHAVEN: I think my previous depression was pretty immature, meaning there were a few times in my life that I hurt myself. I thought about it once in this depressive episode, but I never did it because I thought of my kids and what they would think and what I would tell them. I just have more responsibility, and I can make better decisions now, even in that depressive mindset. So that's different. Now I have a partner that I didn't have before, so sometimes he makes things better. Sometimes he makes things worse in all honesty. He doesn't get it. He doesn't understand why I'm this way, but he wants to. I also have a responsibility to him as the mother of his children to be OK.

KLEINHANS: I had to learn to be a lot more communicative about what was going on up in here that I struggled to articulate. I had to get better at telling him: "I'm not OK. I don't feel good. I don't feel right." It took some time to do that, and he was actually able to tell me: "Well, I don't like it when you isolate, and you go off in a room somewhere and just stay there for hours. That worries me." I never realized that. It's so important to constantly have those conversations, especially with your immediate family and your close friends. I think that's the only way that they can at least learn what it's like for you to be depressed or anxious.

WELHAVEN: There were two people I trusted because I know that they, too, have struggled with mental health. I felt like they could understand, but I just kept my distance with all my other close friends. I didn't say anything to them. I avoided them, and I told them after. They said: "Why didn't you tell me? I could have helped." I didn't even know how to process it myself, let alone try to explain it to anyone.

KLEINHANS: The hard thing is sometimes you really don't know how to describe what you're feeling or what you want to do to fix the problem, or what you think would actually be helpful. Sometimes the only thing you can really say is, "I just know something's off." That becomes a challenge sometimes because they want to know more. But you can only provide so much.

WELHAVEN: It's just a deep-down feeling you can't even put words to. I felt numb a lot.

KLEINHANS: Or just unmotivated like you're in a pit, and you don't see much of a way out of it. You try to do what you can about it. And when one thing doesn't work, you try another thing and another thing. I think a lot of people go through that and end up trying hundreds of different types of therapy or medications just to find the right combination that works for them. That in itself I'm sure is a challenge. I've learned whether it comes to treatment or just coping with it, speaking about it and being open about it can only help.

WELHAVEN: It's still scary, though.

KLEINHANS: I know. It can be. You don't know how it's perceived. I think it will become more and more normalized to have the discussion, admit that it's a thing and then do something about it.

NARRATOR: It's OK not to be OK. If you need help, please connect with a resource or someone you trust. If you know someone who needs help, be supportive and encourage them to reach out. There is hope and there is help. It's OK not to be OK.