Category: This Therapist Has Problems; Mental Health

Caregiver Burnout: When the Strong One Needs Support

Caregiver Burnout: When the Strong One Needs Support

By Natasha Montgomery, M.A., LPC-S, LCDC

There is a question I want us to make more room for: Who is caring for the person who keeps showing up for everyone else?

Sometimes that person is a caregiver helping a loved one through a difficult season. Sometimes it is a therapist, nurse, educator, or parent. Sometimes it is the friend everyone calls because they always seem to know what to do.

Being needed can become so familiar that we stop noticing our own needs. We keep going. We figure things out. And when someone asks how we are doing, we may answer before we have even checked in with ourselves.

For this episode of This Therapist Has Problems, I invited Dr. Carmy Aristor, PhD, ACS, into my office to talk about caregiving, emotional strain, and the vulnerability of needing support. What stood out to me was how much can sit underneath the words, “I’m fine.”

Watch our conversation: https://youtu.be/ZWOXy-aQfYI

When strength becomes something you feel you have to prove

Dr. Carmy shared what it was like to grow her practice while raising her children as a divorced single mother. She described the exhaustion of caring for clients during the day and then coming home to the responsibilities of parenting. She also spoke honestly about the pride attached to holding everything together.

That part stayed with me.

We talk about checking on our strong friends, but we also have to make room for what it takes for that person to say, “I need help.” There may be a story behind their independence. There may be fear of being judged, disappointing someone, or seeming unable to handle a choice they made.

As Dr. Carmy described it, strength can become tied to proving something. Letting another person see the struggle can feel like giving up the very thing you have worked so hard to protect.

I want to be careful here. Difficulty asking for help is not always about pride. Support can also be expensive, unavailable, inconsistent, or hard to trust. A caregiver may need practical relief that cannot be created through a different mindset alone. We can acknowledge those realities while also looking at the beliefs that make it harder to receive the support that is available.

The person underneath the title still needs care

One of Dr. Carmy’s reminders was simple: “Give yourself permission to be human.”

That is part of why I named this podcast This Therapist Has Problems. A title does not remove our humanity. Being able to support other people does not mean we never need someone to support us.

In our conversation, we talked about helping professionals who understand the value of therapy and still feel guarded when they enter the room as a client. Knowing what support can offer and allowing yourself to receive it are different experiences.

You do not have to prove your competence before talking about what is hard. Your need for care does not take away the skills, experience, or compassion you bring to your work and relationships.

And your well-being matters even when you are not being useful to anyone else.

Notice what has changed for you

When I asked what caregivers could pay attention to, Dr. Carmy brought us back to knowing our own baseline. What is typical for your energy, patience, sleep, and emotional experience? What feels different lately?

She discussed becoming more irritable, having less patience, feeling sad, and noticing changes in sleep. These observations can be a reason to pause and seek support. They do not, on their own, tell us what is causing the change.

The Family Caregiver Alliance also encourages caregivers to recognize personal warning signs and seek support before becoming overwhelmed. Their self-care resource for family caregivers offers practical reflection on stress, asking for help, and attending to your own needs.

A check-in does not need to become another complicated assignment. You might simply ask yourself: What am I feeling right now? What has been harder than usual? What have I needed but kept putting off?

If changes persist, worsen, or affect your ability to function, a healthcare or mental health professional can help you understand what is happening. You do not have to decide on the right label before reaching out.

Self-care can begin with noticing what is already there

Dr. Carmy shared an example of someone who wanted to practice more self-care while already making time for the gym. The routine had become so automatic that the person no longer recognized it as a way of caring for herself.

We explored the difference intention can make. Taking a moment to recognize, “This is time I am giving to myself,” may help you notice care that has disappeared into the background of your day.

That does not mean a walk, a journal, or a quiet moment will solve an overwhelming workload. Sometimes what you need is someone to take a responsibility off your plate. Sometimes it is treatment, more reliable help, or a boundary that changes what you are carrying.

The invitation is to notice both: the care you already have and the support you still need.

Dr. Carmy’s four A’s

Toward the end of our conversation, Dr. Carmy offered four A’s as a way to reflect and move forward. These are her takeaways from the episode, not a diagnostic assessment.

StepWhat it means in this conversationA reflection to try
AwarenessNotice what you are experiencing.What feels different for me lately?
AcknowledgmentAdmit what is happening without judging yourself for it.Can I name what is hard without calling myself a failure?
AlignmentConsider the needs, values, habits, and boundaries that should guide your next step.What would support look like in this season of my life?
ActionPut a realistic part of that plan into practice.What is one step I can take or one specific request I can make?

The reflection questions are my editorial prompts based on Dr. Carmy’s explanation. You do not have to complete all four steps perfectly. The point is to make room for honesty and follow it with something practical.

What are we modeling?

We also talked about what our children, clients, and the people around us see. If we only show them that we can keep going, they may never see what it looks like to rest, ask for help, or admit that something is too much.

There is room to model responsibility and humanity together. We can care about our commitments and still acknowledge our limits. We can love the people who depend on us and still need a break.

My hope is that you leave this conversation with permission to check on yourself as thoughtfully as you check on everyone else.

What would asking for support look like if you did not have to prove you could do everything alone?

Meet Dr. Carmy and explore her resources

Dr. Carmy Aristor, PhD, ACS, is a mental health professional, educator, and founder of Destined Horizons Mental Health Practice. Her work focuses on the emotional impact of helping work, including vicarious trauma, compassion fatigue, burnout, and chronic emotional stress. She supports helping professionals in developing boundaries, emotional awareness, and sustainable approaches to caring for themselves.

Guest resources discussed or supplied for this episode:

Additional reader resource selected for this article, not presented as Dr. Carmy’s recommendation: Family Caregiver Alliance: Taking Care of YOU.

Connect with M.B.S. Whole Health

If this conversation brought up something you would like support navigating, you can learn about my counseling, coaching, and LPC Associate supervision services at M.B.S. Whole Health. Counseling is available through telehealth in Texas and Michigan, subject to current availability and fit.

Contact my practice | 682-292-8087 | clients@mbswholehealth.com

Watch the full episode: https://youtu.be/ZWOXy-aQfYI
Subscribe on YouTube and read more reflections on Substack.

My hope is that these conversations help you feel seen, encouraged, and better informed. They’re here for education and connection, and don’t replace therapy, diagnosis, or medical advice tailored to your needs. If you’re in crisis, please contact 911 or 988 as you deserve timely support from a crisis service, as my inquiry form and social media accounts aren’t equipped to provide that care.

ADHD Care: Medication, Holistic Approaches & Finding What Works for You

ADHD Care: Medication, Holistic Approaches & Finding What Works for You

By Natasha Montgomery, M.A., LPC-S, LCDC

“Do I need medication?” “Are there other things I can try?” “What if I don’t feel like myself?”

There can be a lot behind those questions. Sometimes it is fear of side effects. Sometimes it is a past experience of feeling rushed or unheard. Sometimes it is what we grew up hearing about mental health treatment. Whatever brings the question up, I want there to be room to ask it.

In this episode of This Therapist Has Problems, I welcome Dr. Shayla Buckler, DNP, APRN, PMHNP-BC, of The Calming Mind Psychiatry Group. We talk about ADHD care, medication, holistic approaches, and the importance of understanding the person sitting in front of you.

Watch our full conversation: https://youtu.be/8UAyuzkjOrY

What do we mean by holistic care?

When I talk about the whole person, I am thinking about someone’s daily life, relationships, stress, health, and the support they have available. I want to understand what they are carrying and what it takes for them to get through the day.

In our conversation, Dr. Buckler describes asking questions beyond the symptom that brought someone into her office. She discusses sleep, mood, physical health, and the patient’s own understanding of what is happening. Those questions help illustrate the kind of attention that drew me to this conversation.

Holistic care can include medication. The word does not have to mean avoiding psychiatric treatment, and it should not be used to suggest that every natural product is safe or effective. For adult ADHD, the National Institute of Mental Health identifies medication and psychotherapy among common treatment approaches and describes care that may combine several elements. Learn more from NIMH.

Start with a conversation about what you are experiencing

It can be helpful to recognize yourself in someone else’s story. A podcast, social media post, or conversation with a friend may give you language for something you have struggled to explain.

Dr. Buckler talks about patients coming to her with questions about ADHD after seeing information online. She describes taking time to explore those concerns rather than stopping at the first explanation. Her examples are a reminder to bring your experiences into an appointment, even if you are unsure what to call them.

You might write down what is hardest, when it happens, and how it affects your day. Is it starting a task? Remembering what you intended to do? Keeping up at home after using all your energy at work? What has changed, and what has been present for a long time?

You do not need a polished presentation to deserve help. The details you notice can give your provider a starting point. The next steps, including any medical evaluation, should be based on your individual situation.

Medication questions deserve more than a quick answer

One of the parts of this conversation I appreciated most was hearing Dr. Buckler talk about patient education. She describes explaining treatment choices, discussing potential side effects, and following up with patients about their experiences.

For me, that is a meaningful part of care. Agreeing to a plan should come with an opportunity to understand it. If something worries you, that concern belongs in the conversation.

Questions you can bring include:

  • What are we hoping this treatment will help me do or feel differently?
  • What benefits and risks should I understand?
  • What should I do if something does not feel right?
  • How will we check whether this plan is helping?
  • What other support could be part of my care?

You can also tell your provider what makes follow-through difficult. Maybe you forget an appointment, have questions you think of afterward, or feel unsure about bringing up a concern. Those are useful things to discuss rather than reasons to judge yourself.

Daily support belongs in the conversation, too

Dr. Buckler and I discuss calendars, reminders, organization, sleep, and other parts of daily life. I appreciate practical conversations because a treatment plan has to exist in someone’s actual day.

A routine that sounds simple on paper may be difficult when someone is overwhelmed. A reminder is only useful if it is placed where that person will notice it. Support should leave room to learn what works and adjust what does not.

The episode also includes discussion of supplements. That part deserves careful context: NCCIH describes the evidence for many complementary approaches to ADHD as mixed or inconclusive and notes that supplements can interact with medications. Please discuss supplements with a qualified clinician rather than treating a podcast example as a personal recommendation. Read NCCIH’s ADHD overview.

Trust matters, especially when asking for help already feels hard

We also talk about stigma in the Black community and the effort it can take to reach out. People bring family messages, cultural experiences, and prior encounters with health care into the room. I want those experiences to be met with curiosity and respect.

I was encouraged by Dr. Buckler’s emphasis on education and connection. I also appreciated her willingness to talk about her own therapy. As clinicians, we can care about this work and still need support ourselves.

My hope is that hearing two providers speak openly helps make that first conversation feel a little more approachable. You are allowed to ask questions. You are allowed to want a clear explanation. You are allowed to look for care that takes your concerns seriously.

Meet Dr. Shayla Buckler

Dr. Shayla Buckler, DNP, APRN, PMHNP-BC, is a board-certified Psychiatric Mental Health Nurse Practitioner and Assistant Clinical Professor with over 20 years of experience in clinical care, education, and leadership. She teaches and mentors nursing students and contributes to curriculum development across multiple universities.

In clinical practice, she provides compassionate, trauma-informed psychiatric care to adolescents and adults experiencing mental health and substance use disorders. Her approach emphasizes evidence-based treatment, medication management, patient education, and collaborative care tailored to each individual’s needs. She is committed to reducing mental health stigma, improving access to quality psychiatric services, and educating future generations of nursing professionals.

Connect with The Calming Mind Psychiatry Group:

Ask the practice directly about current services, eligibility, insurance, and appointment availability.

Keep the conversation going

What would help you feel more informed and supported in your care?

You can sit with that question privately or bring it into your next appointment. You do not have to decide on a treatment plan from a podcast. I hope the conversation helps you identify what you want to ask next.

Watch the episode: https://youtu.be/8UAyuzkjOrY

Through M.B.S. Whole Health, I offer adult individual counseling, life coaching, and LPC Associate supervision. To learn more, visit https://mbswholehealth.com/contact/, call 682-292-8087, or email clients@mbswholehealth.com.

Additional educational resources

These are additional reading resources selected for this article, not endorsements attributed to the guest:

My hope is that these conversations help you feel seen, encouraged, and better informed. They’re here for education and connection, and don’t replace therapy, diagnosis, or medical advice tailored to your needs. If you’re in crisis, please contact 911 or 988 as you deserve timely support from a crisis service, as my inquiry form and social media accounts aren’t equipped to provide that care.

For U.S. crisis support: 988.

ADHD in Black Women: When “I’m Lazy” Becomes “I Need Support”

ADHD in Black Women: When “I’m Lazy” Becomes “I Need Support”

“I used to think I was lazy.”

That is how Quinn Alston described the way she once understood herself. She knew what she wanted to do. She knew she was capable. Yet getting started, deciding what to do first, and following through could feel much harder than the task itself appeared.

In this episode of This Therapist Has Problems, I sit down with Quinn to talk about ADHD in Black women, motherhood, work, and the emotional weight of trying to make sense of yourself without enough information.

Her story is personal. It also creates space for an important question: What happens when we become curious about a struggle we have been judging?

Watch our full conversation: ADHD in Black Women

When life leaves less room for the systems you used before

Quinn described a shift as her responsibilities grew. Before becoming a mother, she had more room to work around her own timing. With a job, two children, and a home to care for, that flexibility became harder to find.

A task she once could spread across an afternoon now had to fit into the time before someone needed her. The responsibilities increased while the time available to manage them became smaller.

I want to preserve that distinction. Quinn was describing how motherhood made existing difficulties harder to overlook. She was not saying that becoming a mother caused ADHD.

The CDC explains that ADHD begins in childhood and that its effects can become more apparent as adult demands increase. Evaluation also considers a person’s history and other possible explanations, including anxiety, depression, or sleep problems. Read the CDC’s adult ADHD overview.

Being overwhelmed deserves attention whether ADHD is part of the explanation or not.

Getting the job done did not tell the whole story

At work, Quinn’s colleagues saw someone who delivered. They did not necessarily see how difficult it could be to begin a single email, how long she put something off, or how much pressure she relied on to finish.

When she told a coworker about her diagnosis and treatment, the coworker was surprised by how recently she had sought care.

That part of the conversation matters to me. We can appreciate what someone accomplishes and still ask what it costs them to keep accomplishing it.

For Quinn, being seen as capable sometimes meant that her struggle stayed hidden. She was meeting expectations while privately questioning why ordinary tasks felt so heavy.

Her experience also challenges a narrow picture of who ADHD can affect. NIMH notes that ADHD symptoms in girls and women may be missed in childhood. Quinn’s story puts a human voice beside that possibility. Learn more from NIMH.

The list had to become something she could use

One of Quinn’s practical changes was shortening her to-do lists.

A running list of everything she needed to do was overwhelming. She described giving different parts of her life three “dots,” or specific tasks, so she could identify a manageable place to begin.

Her approach was not necessarily three tasks for the entire day. She described separate small lists for work, home, personal needs, and community responsibilities.

What I appreciate is the attention to what helped her act. Instead of “answer every email,” she could identify the one email that needed her attention.

Quinn also prefers paper planners and visible reminders. Undated pages reduced the guilt she felt when she did not use every day. A small notebook gave her somewhere to capture something she wanted to remember.

These are her tools. You do not have to buy a new planner or use her exact system to take something from the conversation. You might ask: Is the way I am organizing this task helping me begin, or making the task feel larger?

A routine could offer structure without so much pressure

Quinn made a useful distinction between a schedule and a routine.

A schedule could feel like a demand to do something at an exact time. A routine gave her a familiar order she could return to.

She described missing a step or a night without deciding that the entire effort had failed. There was room to return the next day.

That invitation reaches beyond productivity. We can build structure without making every interruption a verdict about who we are.

Some responsibilities still have firm times. An appointment or school pickup cannot always become flexible. But there may be other parts of a day where a repeatable sequence fits better than another rigid expectation.

Relief and grief can sit beside each other

Quinn described relief after speaking with a provider who listened. The struggle she had been questioning felt real and acknowledged.

She also talked about the questions that followed: What might have been different if she had understood herself earlier? What about the classes, plans, and attempts she remembered struggling through?

I do not hear those questions as a reason to stay stuck in the past. I hear how much those experiences mattered.

A new understanding can bring hope while also changing how someone sees earlier chapters of life. Quinn’s conversation makes room for both.

It also reminds me that support does not have to begin with proving how much you have suffered. You can ask for help while you are still showing up.

Care was a process, not a single appointment

Quinn spoke openly about working with her provider, tracking what she noticed, and describing what was and was not helping.

Her account belongs to her. It does not tell another person which medication to take or how quickly treatment should work.

ADHD care can include medication and psychotherapy, with an approach tailored to the person. NIMH describes common treatment options here.

If you recognize parts of yourself in this episode, you can bring specific examples to a qualified provider: what is difficult, when it happens, and how it affects work, home, or relationships. A relatable episode can help you find language. It cannot establish your diagnosis.

Questions about medication changes, side effects, caffeine, or alcohol belong with your prescriber or pharmacist.

Supporting someone starts with listening

We also talked about how families and friends can respond.

I want the invitation to be simple: describe what you notice with care, leave room for the person’s perspective, and ask what support would be useful.

That might sound like:

“I’ve noticed you seem overwhelmed when there are several things to manage. How has that been feeling for you?”

Or:

“Thank you for telling me. How can I support you?”

You do not have to diagnose someone to take their experience seriously. You also do not have to dismiss a diagnosis because that person seems successful or because you have never seen their hardest moments.

Quinn’s vision for community

Quinn is the founder of Limitless Black Women, a new organization created for Black women navigating ADHD and anxiety. Drawing from her own experience with ADHD, she is building the community, real-life tools, and connections to culturally competent providers she wishes she had sooner.

She also serves as the operations lead for DFW Black Moms Walking Club, where she helps build the infrastructure that supports the community. Across both roles, her focus is creating structure that frees women to show up for their families, their communities, and themselves.

Limitless Black Women is launching soon. You can learn more through the website below.

Connect with Quinn: https://www.limitlessblackwomen.com/

A question to take with you

What have you been criticizing yourself for that deserves a closer look and more support?

You do not have to answer publicly. Write it down, bring it to someone you trust, or use it to begin a conversation with a provider.

Quinn’s closing encouragement was to be gentle with yourself. I hope you carry that with you as you decide what support you need next.

Watch Quinn’s complete conversation: ADHD in Black Women
Read my separate personal reflection, “You Can Be Proud and Still Grieve”: ADHD in Black Women

About Quinn

Quinn Alston is a DFW-based wife, mother of two, and HR professional specializing in employee benefits operations. She serves as operations lead for DFW Black Moms Walking Club and is the founder of Limitless Black Women, a new organization for Black women navigating ADHD and anxiety. She is passionate about building practical systems that help women show up fully for their families, communities, and themselves.

Resources mentioned in our conversation

Additional educational resources

These additional resources were selected for readers; they are not presented as Quinn’s recommendations.

Work with me

Through M.B.S. Whole Health, I offer adult individual counseling, life coaching, and LPC Associate supervision. Explore services or send an inquiry.

M.B.S. Whole Health | 682-292-8306 | info@mbswholehealth.com

Stay connected: Instagram | Facebook | LinkedIn | YouTube | Substack

My hope is that these conversations help you feel seen, encouraged, and better informed. They’re here for education and connection, and don’t replace therapy, diagnosis, or medical advice tailored to your needs. If you’re in crisis, please contact 911 or 988 as you deserve timely support from a crisis service, as my inquiry form and social media accounts aren’t equipped to provide that care.

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