Building mental resilience on the farm: a talk with a psychologist and farmer

Calving, planting, and harvesting are the lifeblood of the farm and ranch. The new beginnings of spring calves and seeds and the completion of harvest in the fall are the things we as farmers and ranchers live for. But what happens when these busy seasons start to pile up and you go from excited to a little bit more… stressed?

In today’s episode, hosts Emmery Mehlhoff and Alisha Nord visit with Dr. Amy Missling about stress on the farm and how it can turn from something seasonal to more permanent: chronic stress.

Dr. Amy Missling is a licensed clinical psychologist and practices in rural Minnesota.  She specializes in the treatment of anxiety disorders as well as trauma and stressor-related conditions.  She provides behavioral health services to adults with a variety of life circumstances and occupations, including local farmers and ranchers.  Outside of her work as a psychologist, she and her husband, Jeff Missling, feed cattle and hogs and co-own a meat locker in Devils Lake, N.D.

Dr. Missling shares her experience as a psychologist and agriculturalist. Marrying into agriculture has given her a unique experience about the kinds of stress farmers and ranchers are facing.

We talk about: 

• The kinds of stressors farmers and ranchers face 
• Warning signs to look out for that stress is becoming chronic
• Is stress always bad? 
• What you can do to manage stress on your farm and ranch  

Check out your level of stress here

For more information about how to find a behavioral health specialist, visit with your primary care doctor.

Farm Bureau Member? Visit KonnectMD on NDFB’s member benefit page  https://www.ndfb.org/benefits/ 

Contact Emmery and Alisha at @emmery@ndfb.org

Transcript

[Straight Talk theme]

[00:10] Emmery: Welcome to Straight Talk with NDFB. I am your host, Emmery Mehlhoff 

[00:14] Alisha: And Alicia Nord. 

[00:16] Emmery: We are your Farm Bureau duo bringing you your competitive edge.

[00:19] Alisha: Today we visited with Dr. Amy Missling, who has 15 years of experience as a psychologist. Dr. Misling shares her unique experience marrying into the agricultural world and how stress plays a role in the lives of farmers and ranchers.

[00:34] Emmery: Today we visit with Dr. Missling about the different stressors that farmers and ranchers face. Warning signs to look out for, whether stress is always bad, and things that you can do to manage the stress on your farm and ranch. Join us for this episode. 

[Straight Talk stinger]

[00:53] Emmery: Welcome to Straight Talk with NDFB. Today I am really excited because Alisha and I are visiting with Dr. Amy Missling, who I am excited about talking about for multiple reasons. The first one is that she is Jeff Missling's wife. He is the CEO of Farm Bureau, and I am grateful that he decided to share her with us today. But secondly, I'm excited because she is a therapist who works with behavioral health. So we're going to dive into those subjects today. Dr. Missling, could you just tell us a little bit about yourself and just give our listeners a little bit of background on what you do and who you are?

[01:34] Amy: Absolutely. Thank you so much for having me on your show today. I'm excited to be able to share a bit more about stress and how that pertains to farming and ranching and agricultural industry. So, yes, my name is Dr. Amy Missling. I am a licensed clinical psychologist. I've practiced for over 15 years and have provided general mental health services. And in recent years, my area of expertise has kind of begun to focus more on the treatment of anxiety disorders, acute and chronic stress related conditions, including trauma, and the impacts of trauma in one's life and on the body, the mind and body. It's been a real joy expanding on this area of my practice. And I find that it's very relevant to everybody, so it's extremely relatable to all. I am excited to talk about agriculture today. I do have connections to agriculture, like you mentioned, my husband is Jeff Missling. Jeff and I feed some hogs and cattle. We raise alfalfa, and we also co own a meat locker in Devils Lake. So I have personally become a lot more involved in agriculture and the joys and beauty and gift of agriculture, in addition to the stressors that come along with the industry.

[03:01] Emmery: Did you grow up in agriculture related, or is this a new world for you?

[03:07] Amy: Great question, Emmery. I did not grow up in agriculture. So this is really new to me. I grew up in the Twin Cities and was a city girl. Jeff was involved in agriculture his entire life. And so he has got know. I know, like most farmers and ranchers, it's in their blood, and now it's seeping into mine. I love it; to raise the hogs and cattle and alfalfa with him. I think it was about four years ago or so that I got more involved actively on the farm, running the tractor. I've spread manure, I've raked hay, getting out there, doing chores, carrying the buckets, all of it. And it's such a... being in nature, being with the animals. It actually is a stress relieving activity. Right? Like, being with them is such a gift. And then along with that, it can create a lot of unknown variables and stress.

[04:05] Emmery: So you are uniquely equipped to talk about this as well. Coming from non-agriculture into agriculture have a very unique insight. So I guess that kind of dives into our topic here, which is stress in agriculture, and like you said, chronic stress and other conditions that come along with that. So, can you tell us a little bit about how stress is relevant to the farming and ranching industry?

[04:32] Amy: So, that's a good question, Emmery. When I think about the concept of stress, I think about the nervous system and the impact that our world around us and our circumstances has upon our mind and our body, so interrelated. And so myself now, being involved in agriculture and knowing a lot of farmers and ranchers, we know that agriculture comes along with high stress, high demands, threat of loss. We certainly can talk about the many stressors, but there are so many variables in agriculture that are out of one's control. So we're often responding to many unpredictable circumstances, and that has a pretty profound, at times, impact on how our nervous system reacts. Thinking about the industry itself, there are many uncontrollable factors in the high stress and demands in agriculture. And that is why I think it's so important to get the word out there that learning how to manage stress within farming and ranching is important.

[05:38] Emmery: I mean, you touched on this a little bit, but what are some of those stressors? I don't know. When I think about it, I can think about five things off the top of my head related to our farm and ranch that makes me stressed out. But what do you see as those top stressors within the agricultural field?

[05:59] Amy: So, really, almost anything could be considered a stressor, right? Because it's something that we perceive as uncontrollable, or what we use term threat. But when it comes specifically to agriculture, some common ones that I run into in my practice, my personal life. I know others have reported uncertainty with weather, seasonal variations, tariffs, commodity pricing. If you have a breakdown on the farmer ranch, need to make a repair, but maybe you don't have access to the spare parts, or you need to get something done on a time crunch, and that might not happen because of the weather, because of equipment failure. Fear of losing the farm if it's a multigenerational operation, which adds that extra pressure. Losing livestock, if there are personal or family health concerns. And that limits the extent to which one is able to be involved in the operation. And then speaking of personal or family health concerns, a lot of times farms and ranches are family operated. So that means they may have disagreements or conflicts, which can certainly create both occupational and personal stress. A lot of responsibilities working late into the night to put in crops, which can lead to fatigue, poor sleep. So these are just a few of the many types of stressors that people have reported.

[07:27] Emmery: Oftentimes we say that finances are the primary stressors that people face on their farms and ranches, just tight years. But recently in our podcast season, Alicia and I have uncovered in talking to many different succession planners, financial planners, et cetera, that one of those primary stressors is exactly what you mentioned, which is family and family relationships. And I had really underestimated how stressful interpersonal things can be, which, I mean, it really makes sense because probably in every other area of life, the thing that causes the most stress could be a dysfunctional relationship. But for some reason, I hadn't translated that to the farm and ranch. So I think that's really insightful, is thinking about how much your relationships or working with family, or even working with a partner can add stress if that's not a functional relationship. So that's really interesting.

[08:28] Amy: Absolutely. And even if it is functional, we all manage and deal with stress differently, and it has different impacts on us. So depending on how one partner, one spouse, is responding to stress and the other one responds, that might escalate conflict. We all handle conflict differently. So when we're out on the farm and then we come inside and we're having dinner together, and we can't really separate the two, that doesn't give our bodies right, our minds, our bodies, our nervous systems, an opportunity to what we say, regulate or kind of soothe a bit between work and home. It's so muddled together in a way, hard to have those boundaries and separation.

[09:10] Emmery: I want to talk a little bit about stress itself. You hear the word and it sounds like a negative thing, but, for example, working out, et cetera. If you stress a muscle, you know, it hurts for a while, and then it grows and gets stronger. So, does stress always have to be bad, or can it sometimes be a good thing?

[09:29] Amy: Yeah, I love that metaphor, Emmery. That's great. Just like the muscle example you gave, not all stress is bad. Actually, we use the term ustress to reflect positive stress, because, really, stress itself is healthy. To be stressed, what it does to our brain and body is it enhances performance. It helps us to focus better, to feel motivated, driven, to retain, recall information. But really, there's kind of an optimal level of stress that we function best with. And then once it tips the scale and our nervous system gets overstimulated and we're not quite as regulated, that's when stress can have more difficult impacts on our functioning, our mood and symptoms.

[10:23] Alisha: So that was kind of a question I had, because I feel like, growing up, I never really heard the word stress or depression or anything like that. And now I feel like it's a very common word with just asking somebody, "How are you?" And it's, "I'm so stressed out." Do you think that word is overused today? Or do you think people maybe have that confused with, I don't even know what it would be like, another emotion with how they're feeling. Maybe they're anxious, but they're using the word stress. Like you said, there's good and bad, but how do you know this is an unhealthy level of stress, or this is an okay level of stress, and next week it will be better once I get through whatever it may be. How do people know what the difference is and when it becomes not healthy?

[11:17] Amy: That's a great question. That word, that kind of term, "I'm stressed out," right? Or "I feel so stressed." That is commonly used. And I think the reaction of stress, what happens in our bodies and our brains, is a very natural response that our nervous system is designed to have. We're designed to face things that might be out of our control or unpredictable, and then our nervous system has its response. And the difference between having a response for a nervous system and then this concept of being stressed out is usually when people are at the point of saying,"Oh, I'm so stressed," or stressed out. It can be an indicator that their nervous system has been activated for longer than is beneficial. It kind of has tipped the scale from optimal stress levels to higher or more. The duration of time is longer than what it might be designed for. So our stress response is a very natural response meant to be activated temporarily. And then once the stressor subsides, we get back to a regulated level in our nervous system and move on to function. Typically, when someone is at a point of saying, "Oh, I'm so stressed." They've encountered a variety of uncontrollable situations, circumstances that have made it difficult for their nervous system to rest, to get back to a resting state. 

A lot of times, what people will experience, and it can vary. I mean, the signs and symptoms of chronic stress could be almost anything, Alisha, honestly. And it is so important to be aware of those signs and symptoms. So I break that down into different categories. If you can think about it as emotional things that you may begin to notice in yourself. Physical symptoms, mental symptoms, and behavioral symptoms, kind of breaking it down, or signs or symptoms into how we're functioning differently. If we begin to function differently, behave in ways that aren't very characteristic of us, our thinking starts to change. Our emotional tendencies are shifting. That's often a sign that this is chronic stress, and I need to do something about it. And I can name some of those symptoms if you want me to expand on that.

[13:46] Alisha: Yeah, go right ahead.

[13:47] Amy: So, when we think about emotional signs and symptoms of chronic stress, again, it could be anything. But some possibilities are maybe feeling more nervous or fearful or anxious. That's kind of a common one that people often identify with stress, but it certainly expands beyond that. Could be feeling more sad or down helpless. Another common symptom is being more angry or irritable with loved ones or people that you interact with, or maybe frustrated more easily. Feeling guilty more quickly. And then on the other end of the spectrum is sometimes just feeling shut down or not having interest in things that one usually enjoys, feeling almost numb or disconnected from others. So it can look maybe like an anxiety disorder or depression, as I name some of these symptoms. But actually, it could be chronic stress in that nervous system being overly activated for an extended period of time. 

Some physical symptoms might include being dizzy or faint, changing in breath or breathing, increased heart rate. Other common things that people report are physical pain. So they might start getting more headaches, digestive issues, maybe stomach aches or heartburn. There can be changes in skin, like more skin irritation or mouth sores. Our body, it's just incredible how our body tries to tell us and show us that we need to attend to it and manage that reaction that we're having. We might get sick more often. That is very common with chronic stress. Appetite often changes. We might be more hungry or less hungry. Energy levels often change. 

And then mentally, our thinking often shifts. So we might worry more, have racing thoughts, or even struggle remembering things, maybe like, what is going on? I just can't find the words, or I can't remember what I just did. Or we might find those instances happening more often, and that could be an indicator: "Okay, I think I'm in a point of high chronic stress." Another important one to note is having suicidal thinking or self harm thoughts. That can be an impact of chronic stress.

And then behavioral changes. We might be more impulsive, argue more, begin using substances. I know alcohol is a common substance that people use in kind of a subconscious way to try regulate that nervous system. It's an attempt to try manage that stress level in our body. And then sleep changes are quite common as well, having disrupted sleep, troubles falling asleep, staying asleep, or even self destructive behaviors or reckless behaviors. So kind of as you can hear, it's like a very wide range of changes that people might experience that could indicate chronic stress.

[16:56] Alisha: Thank you for going into detail about that, Amy, because, as you know, one of the reasons why we wanted to have you on this podcast is because we all know that within the farming and ranching community, reaching out for help is something that is really hard for our members to do. So we want this episode to really be as helpful as possible for somebody that might be listening, that is going through struggles. So I really do appreciate you going into some detail. So, going back to the chronic stress part, if they know there's something wrong, they know they're not themselves, whether it's one of the symptoms that you just stated, and they don't feel comfortable reaching out yet, what are some things that they can do to try to figure out what is this chronic stress that is causing A,B,C and D? What are some things that they can do themselves at home to try to figure out what might be causing this in their life?

[18:00] Amy: It can be difficult, I find, for people to identify at times, all of the different things that may be causing the stress. But I think one really beneficial or helpful way to get more aware is to talk with loved ones, asking people you trust, feel safe with, "What are you noticing?" Because if we're not seeing it ourselves, often people that we love have a much clearer lens of what they're seeing. So asking if they notice any patterns. I think finding patterns is a really helpful way to begin identifying triggers to these changes that one might be experiencing. Noticing,are there days that maybe I function better or sleep better, and then days when I'm noticing that maybe I don't have quite as much motivation, kind of tracking changes from day to day to see if people are finding any trends in their behaviors or their symptoms or their ability to function. So I'd say tracking is probably the best way at home to try determine what is contributing to the stress response that is occurring.

[19:12] Alisha: If you were to figure out, I know calving season stresses me out, like, that is what is causing all my anxiety and all my stress, and I know I need to do something about it. Is there a way to manage the stress while still, for example, keeping your cows, or do you have to completely get rid of that stressor in your life? I don't know if that made sense or not.

[19:40] Amy: That makes perfect sense. That's such a great question, Alisha, because in life in general, we can't just remove the stressor, right? Like in farming and ranching, it's our livelihood. So it's really not realistic or feasible to say, get rid of all the livestock, right, or any kind of significant change, because like I said, that's their livelihood. So what I recommend and what someone can do is preparing yourself once you know the trends of stress changing in your body and how symptoms begin to show up, recognizing and preparing for that time or season of life. So, for instance, if one knows that spring is going to be higher stress with calving, they may want to ensure that they have a plan of action to make their home environment more manageable. Planning and preparing is probably one of the most helpful ways that one could manage this, Alisha.  Knowing seasons and times that are going to be harder to manage, and then practicing skills and tools throughout those seasons so that you can try keep that stress response under control. Knowing things that are soothing for you, things that offer some mental breaks. Because it's not like people during these busy seasons, often in farming and ranching, can leave for a vacation, right? Like, I can get away. That's just not possible. So it'll be in the moment activities that help calm and soothe that response. And often during stress, how we function is kind of an automatic pilot, and that just exacerbates the response that our mind and body are having when we're in a chronic stress state. One example is beginning to be very intentional about how we are living each moment, being very present with our mind in each moment to calm the spinning of the mind. So what that would mean then is practicing soothing and regulation skills during, before, after these stressful seasons so that we can manage stress.

[22:01] Alisha: And I think that kind of goes back to what Emmery was talking about, how family and working with family can really add to that high stress. But then when you think about it, if you're really stressed out about what you're doing or you have a family member that is. That's only adding to the family dynamic. And so this kind of just got me thinking. So I'm probably going to spiral down a rabbit hole. But it just got me thinking that you might think you have a problem with a family member when really you're just stressed out about a certain situation or a certain aspect of the farm, and it's relaying over into your relationship with whoever you might be working with.

[22:47] Amy: Absolutely right. That increased conflict or frustration could be a symptom of your own personal stress versus an interpersonal problem.

[22:57] Emmery: Yeah, you're actually the problem, or at least a significant contributor.

[23:02] Alisha: I'm doing some inner reflecting right now.

[23:07] Amy: I really like to remind everybody I work with, including myself, what's happening in the body is not problematic. This is our nervous system's attempt... At the end of the day, stress is about our nervous system trying to protect us, trying to help us through what is being perceived or experienced in our body as danger. Right. So no matter what the thing is that our brain is perceiving as a threat, our nervous system is going to react the same kind of way. The pattern of what happens physiologically is the same. I think people can get really hard on themselves. "Oh, my goodness, I'm the problem. What's wrong with me?" And really, when we recognize what's happening, normalizing it, and then feeling equipped to manage that response in a little different way so that our nervous system isn't being overstimulated. 

[24:03] Emmery: What does that look like practiccally? I mean, it's probably person and situation specific, but I would say one of our most stressful times is during planting season, where you're working long hours. Usually Dad is out there working 16 hours a day, and usually I'm along there working a big chunk of that as well, and then have kids tagging along and just all of the added stress of the weather and all of that. So what does it practically mean to have awareness and manage your stress load and make allowance for it, or I guess plan for it? What does that practically look like mentally?

[24:41] Amy: I break it down into non-therapy kind of things, like, what can we do just behaviorally? And then there are obviously tools and skills that one can learn are taken from a therapy space, right? So breaking it down: So some things that we can do just that help to regulate and manage the nervous system response is something that Alisha had asked. So becoming more aware of the triggers that activate this pattern and then decreasing substance use. So if somebody is finding that they are using, say, alcohol more to cut back on their use, because that has an effect on the nervous system, actually, and causes it to dysregulate more than regulate. And it actually agitates our nervous system. Alcohol does, when it exits the nervous system. Prioritizing activities, kind of breaking them down into manageable bits so that you can focus on the most urgent needs first. We can often feel like, "Oh, my goodness, there's this wide range of things that need to be done." And trying to break it down so that the mind doesn't feel so overwhelmed and go on to threat mode, right, and get activated. 

Technology can be a big stressor. So turning off technology or notifications at designated times. I often encourage people to have no technology times, if possible, if that's a possible thing on your operation. So that you don't have a million other demands coming from other directions and you can't just focus on the task at hand. Taking a look at really negative or extreme thinking patterns and working to try reframe that or getting perspective from other loved ones so that we can widen the lens of how we're viewing things. And then a lot of research is showing the benefits of so many day to day things that we're already doing that have a really powerful effect on regulating our stress response. So calming music, having anything in our space where we might be experiencing stress, adding elements that are calming. And then I often encourage people to set aside time to intentionally rest your mind. Even if it's just two minutes. If you've had a really busy day, say you were up all night, calving, and it's continuing into the day, that's obviously going to have an effect on your stress level. So finding a moment, even to just pause, close your eyes, take some deep breaths to get grounded again back into the.

[27:23] Emmery: Moment makes me think of sometime in the. Had a pretty severe head concussion and head injury. And I know getting back into the tractor was a significant thing for me to do, because that was one of the most significant things for me, coping wise, was just because it was long hours in the tractor, just going, lots of sounds, lots of beeping. And your brain is kind of on overload from concussion and everything. And so jumping out of the tractor to either use the natural facilities or just to take a break. And then what I would do is I would just sit in the pickup, or I'd sit in the ditch or something, and I would plug my ears and close my eyes and just sit there for, like, five minutes, or even sometimes two minutes, if it was in between, if we were harvesting and I was in between grain cart dumps, and I would just sit and block out any stimulation at all. And then it was amazing. Like, I was just able to jump back in the tractor and go again for hours. And so I just wanted to throw that little story in there as a testament to that.

[28:29] Amy: Yeah. And that's such a good example, Emmery. Thank you for sharing that, of how we already, our bodies and our minds, they often know inherently what we need. It's just paying attention to what it's telling us, which can be really difficult right when we're in the middle of craziness and busyness and high demands. But naturally, our bodies and minds really do tell us what we need. And it's listening to that, right? So you had that awareness, whether it was conscious or just kind of this automatic reaction. What a skillful thing to step away. Pause. Sometimes I'll talk about that sacred pause. Just giving yourself that space, silencing your world around you the best you can. Shifting senses, the sensory experience that you're having, which really does help turn the dial down on the nervous system, gives it space, and then we can get right back to it.

[29:29] Alisha: And that kind of goes into, I don't know, the world we live in today. It's such a go go go society, and you got to say yes to everything, and you have to be in every sport and go to every meeting and be on every committee. And it just goes to show you that by doing that, can really bring your body to a lull, and you might not even realize why you're not functioning at full capacity and that it's okay, like Emmery said, just to say, "Hey, I need to take two minutes," or "I can't make that meeting tonight." You obviously don't have to say what you're doing, but just sitting at home in silence, whatever it may be, but making sure that if you are not feeling 100% or you just know something's off, to treat your body right and to give yourself that time so that you can heal and go back to your normal life and be active and be in everything that you want to do. But knowing that there is a tipping point, where it's too much.

[30:29] Amy: Yes. And respecting that, right. That there's nothing wrong with us when we have a tipping point. That we all have a tipping point, that it's too much, our system is overstimulated. And then honoring that. There's nothing wrong with us, but we need to listen to it, acknowledge it, and then explore. Sometimes it is trial and error, right? Explore what I can do to get back within a manageable sphere again, to function, keep functioning. And that word boundaries that you used, Alisha, that is so powerful because often when we are highly stressed, it can be harder to set boundaries because of the effects that stress has on our whole system. So being very aware of how much am I committing to and giving ourselves permission to say no sometimes in some of these seasons, I know I have to prepare myself to say no. Or maybe I can't attend those meetings as frequently and I can let them know ahead of time so that you can navigate balance.

[31:31] Alisha: Yes. And one thing I just got thinking that I appreciate my close friend group even more now is we all live across the country, so it's really hard for us to get together. And when we do or when we're trying to plan something, we are now on that level where if you can't make it work, or whatever it may be, there's no explanation needed anymore. It's not, "You have to list off the 15 things you're doing," or even if you're not doing anything to make something up, because you feel guilty that we have this thing that if we're trying to plan something and you just don't want to go or it doesn't work out, you don't need to justify yourself. You don't need to explain really anything in your life to anybody. It's crazy because it's such a small thing. It really isn't because it's usually over text message, too. But just not having to feel like I have to explain myself, it's crazy the amount of stress that is relieved from not having to do that. I just say I can't make it, have fun and that's it. And I move on with my day. It's crazy how something so small has such an effect on your brain.

[32:44] Amy: Definitely. Because now you're not anticipating. Your brain isn't anticipating, "Oh no! Threat! They're going to be mad at me or I'm going to lose my friends," right? It's just this respect and understanding. And I think the more that we as farmers and ranchers can acknowledge that with our friends and our family and preparing and setting those limits and respecting them, the healthier we can all be, right. The less anxiety we can have about needing to take care of ourselves during some of those high demand times.

[33:15] Emmery: When is the time to reach out to an expert or ask for some help? I know a few people in my life that, I don't know, have ever walked into a therapy department before. But that's a silly thing to say. But when should somebody look at talking to somebody such as yourself, or looking for some help with behavioral health or mental health or whatever we want to call it, and then what does that process look like? I mean, it can seem like an intimidating course of action.

[33:53] Amy: That's a really important question to consider, because there's no right or wrong time for anybody to seek out the support of a behavioral health specialist. However, there tend to be more common times when people are struggling to function on their own, and they may notice increase interpersonal concerns or struggles with functioning or performance, that begins to change. And that would be a time when someone would want to consider seeking out behavioral health services, because sometimes people will step into my office and they're really early on in this process, and they're just starting to sense that they have some stress. That's a really opportune time to start adding to that toolbox and equip them to manage stress. And oftentimes people end up in my office when things have begun to get more difficult to control or manage, and so either end of the spectrum is appropriate. But often, if someone is struggling to manage stress on their own, they've tried some of these basic tools and they're just not noticing any improvements. That would definitely be the time to consider finding somebody, and I'll definitely go into more about that in a moment regarding how to find the right help. So performance and functioning are beginning to deteriorate or change. If someone's isolating more or avoiding activities, avoidance is a pretty common indicator that it's time. Most certainly if people are having thoughts of wanting to harm themselves, if they're thinking that maybe life isn't worth living. Questioning suicide, that's absolutely an important time to seek out support. And if love ones, you know loved ones are a really good compass on our state and where we're at. So if loved ones begin expressing concerns and noticing changes, that can be important to pay attention to, and then definitely if someone's beginning to use alcohol or other substances more often, it would be an important time to work on managing the behavior in addition to the stress.

[36:05] Emmery: Yeah, like you said, how do you find that person then? What is the process to find somebody that's trustworthy and isn't going to be weird?

[36:15] Amy: The beauty, I think, of the world we live in is the access to care has really grown to receiving behavioral health services. There are so many avenues that we can go in, and yet sometimes that can feel really daunting, right and overwhelming. How do I find the right fit? And that can take time. I really encourage people not to get discouraged about the process if they're able. The first person that you meet with might not feel like the fit. You may not feel comfortable, and that's okay. I always encourage people to try again if it doesn't feel quite right. 

But a good place to start with seeking out services is meeting with your primary care provider. A lot of healthcare systems now have access to behavioral health departments, often right within their healthcare system. So that primary care provider probably has direct access and communication with providers in their behavioral health department. And another important reason meeting with a primary care provider is so beneficial is that they can assess if there are any underlying medical conditions that could be causing some of the problems that people are experiencing. They can evaluate, do we have any nutritional, like, vitamin deficiencies? Some deficiencies can actually mimic depression or mimic other conditions. So getting a full workup to ensure that everything is okay, and just to evaluate the impacts that stress is having so that you can get all the right resources in place, but that can be a really helpful place to start is getting a referral from a primary care provider. 

And a lot of behavioral health providers now offer in person and virtual options for services. And really, as we've been doing far more virtual treatment or telehealth treatment since COVID began, we're finding that the effectiveness, the benefits of it are equal to in person work. So not to be afraid of that option, especially living in rural areas. It is such a gift to be able to provide telehealth services. And also to consider when you're meeting with your provider that you might need to meet with a medication provider. So a psychiatrist or a psychiatric nurse practitioner, potentially even your primary care provider, can look at, are there any medications that could be helpful, get things back on track? And then I think sometimes it's confusing for people, like, what does it mean if they're a social worker? What does it mean if they're a psychiatrist, a psychologist? There are so many different kinds of counselors or therapists out there. Sometimes people have their own specialties, so you might need to make some calls. But social workers, psychologists, licensed professional counselors are all the different kinds of options. Licensed marriage and family therapists are all different forms of counselors or therapists that can provide this work. And then I often recommend look up their profile, if they have access online to a video or a description or a narrative of their biography and the kind of work that they do, I think it's important to do a little research on them, maybe even call them and ask, "What's your specialty? What kinds of things do you tend to focus on in your practice?" so that you don't waste a visit and that's not something that maybe they work on in their practice.

[39:39] Emmery: Amy, I really appreciate your insights and your perspective coming from the field that you work in and having not grown up in agriculture, but now being in agriculture and having a unique insight into the different things that people face, I really appreciate you sharing your wisdom and your advice with us today. Are there any other resources that people could pursue, whether on their own or looking through other venues as far as seeking out help?

[40:09] Amy: Yeah. So there are some really nice tools that people can use. So one tool that is free and you can gain online access on your own is called the perceived stress scale. And that can be completed, an easy ten question questionnaire that just gives you potentially a sense of the level of stress that you might have experienced in the last month. And that can be a helpful indicator that maybe it's time I either intervene a little bit more with some of my at home skills or consider finding someone, a professional to support me in managing my stress. 

Yeah, if you are a member of NDFB, they have access to a resource called KonnectMD where you can, it sounds like, receive primary care services as well as behavioral health treatment, and they do offer virtual support through those services. So that's kind of a neat opportunity, if you are an NDFB member.

North Dakota Human Services has some really great resources for farmers and ranchers, and you can look up North Dakota Human Services and they offer services throughout North Dakota for people who might be seeking out behavioral health services in different counties.

[41:33] Emmery: No, I really appreciate you visiting with us today, Amy, and for providing your insights and wisdom from your area of expertise into the agricultural world. And thank you so much for joining us today and I hope you have a wonderful rest of your year.

[41:48] Amy: Thanks so much for inviting me on your show. I had a really nice time chatting with you and appreciate the time.

[41:54] Alisha: Thanks, Amy.

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[41:58] Emmery: You've been listening to Straight Talk with NDFB. To learn more about resources that can help you and your family manage stress on your farmer ranch. Check out our show notes below. To contact Alisha and myself and to learn more about Straight Talk with NDFB, visit us at ndfb.org.

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