The Moos Room™

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Emily: Welcome everybody to the Moos Room. Once again, OG3 and our third episode in our mental health series for the month of May. We are joined today by a very special guest, probably one of the most special ones we've had. I'm not just saying that to be a brown noser. We are very excited to have a longtime fan of the show, one of the original fans of the show, I think. You've been with us for quite some time and a dairy farmer in Iowa. We are joined today by Kevin Dietzel. What's up, Kevin?
Kevin Dietzel: Hey. So happy to be here.
Emily: We are so happy to have you. I know Brad especially, is excited because you are a grazing dairy.
Bradley: That's right. Exactly. He's doing some very interesting things there with his cows too. It's always a good thing and we've had lots of conversations across Twitter and many different areas, so it's happy that finally you're here.
Emily: We were so excited that you said yes that you wanted to be on the show. Before we get into it though, and I mean this is a little unfair because Kevin's a longtime listener, so he knows what's coming, but he is a guest, so he needs to be asked the two not-so-secret questions to him. Joe, go ahead.
Joe: All right. The not-so-secret questions to Kevin. Kevin, we need to know your favorite beef breed first.
Kevin: You're going to have to start a new category for this one. I hope I'm not breaking any rules. I'm going to say, Normande.
Bradley: We will accept that.
Joe: Yes, absolutely. Actually, it hasn't come out at the time we're recording this, but someone threw in a dairy breed on the beef side last week. Meg said Jersey last week, so let's run through the total quick. That is Angus at six, still leading, still out in front ahead of Hereford, which is the only important thing. Hereford is at six, Black Baldy, two, Belted Galloway, two, Brahman, one, Stabilizer, one, Gelbvieh, one, Scottish Highlander, one, Chianina, one, Charolais, one, Simmental, one, Nellore, one, Jersey one, and now Normande with one. All right, let's go to the dairy side. What is your favorite dairy breed, Kevin?
Kevin: Okay, this is where I'm not sure if this is allowed. I'm going to say Normande for my daily breed too.
Emily: Oh, okay.
Bradley: Yes, that is perfect.
Joe: Yes, definitely allowed. We actually had-
Emily: That is allowed. I like it.
Kevin: I'm taking advantage of the dual-purpose breed there.
Joe: Absolutely.
Emily: Exactly.
Joe: Brad's a fan.
Bradley: I am. That's the second-best answer.
Kevin: I didn't say Holstein so I didn't give you guys--
Bradley: Hey, that's right. Yes.
Joe: You didn't widen the gap, so that's good. All right, let's hit the totals. Holsteins at 11, Jerseys at eight, Brown Swiss at four, Montb�liarde at three, Dutch Belted at two, and now Normande at two as well.
Emily: I'd love to get a little bit more variety in there, so that's good. Kevin had plenty of time to prepare. Usually, people are put on the spot, but he knew what was coming. All right. Before we really dive into it, of course, this is part of our mental health awareness series for the month of May, but first I just want to give a little background and let Kevin give a little background. Similar to Bradley, I have communicated with Kevin quite a bit on Twitter, so I will give a plug right now. He's at Lost Lake Farmer. Give him a follow, lots of great photos and videos. That is my favorite thing about following you, Kevin, and I share your stuff with a lot of my non-farming friends because you just do a really great job.
I am going to let you tell just brief overview of your farm. Bradley, you are allowed one farm-related question, so make it a good one.
Kevin: Since you're plugging my social media, I have the same handle at Lost Lake Farmer on Instagram and TikTok.
Emily: Oh, nice.
Kevin: You can follow me on three different forums with the same handle. I don't always have the same content, it's usually different. If you follow me on one, it's worth following me on another because it's different pictures, different videos. Every once in a while I'll have some crossover, but anyways.
Emily: Good promo, Kevin.
Bradley: Oh, I got to check out TikTok.
Kevin: Yes, just a little bit about our farm. It is me and my wife, Renee, and we are the main owner-operators. We are Lost Lake Farm, LLC, and LLC is because we actually went different route of getting startup funding and we have 12 different investors who are co-owners in the farm. We own 51%, myself and my wife, and then the other 49% is owned between 12 different people, they all have different amounts. Some people we've known a while, some people we met when we went out in the community, we did some pitches and had some community meetings to try and recruit investors. We went out of the box there because what we were trying to do didn't fit the standard model and getting financing wasn't happening.
We have 80 acres on the home farm. We own four, so we own the house, and buildings, and yard, and a little bit of pasture. The rest we rent for my aunt and uncle who bought it as an investment and rent it to us at market rates. We're milking 20 cows and turning all the milk into cheese on farm. We milk once a day and right now it's in the afternoon, normally it's in the morning. It's a different situation because we don't have an employee right now. Normally the employee milks the morning then I make cheese because I'm busy making cheese, but without an employee to be able to feed it into the day, I do it at the end of the day. Hopefully, that'll shift back to the mornings again pretty soon here.
Then we also have a few pigs that we feed the whey to. We soak feed in whey. Sometimes have them on pasture, it depends on time. If I have time to set up fence and get a group trained and that sort of thing. We are not certified organic, we follow mostly organic things. The main reason we're not organic is because the way we market, which is mostly direct sales, we don't really need a third-party certification, is the main reason. Organic certification takes a lot of time, a lot of paper paperwork, and there is some cost to it.
The other reason is we like to have antibiotics as a tool if we need it. That is the one thing that I disagree with there. We try not to use antibiotics but there are times where this is the best tool and maybe that is because of a previous failure or whatever, but there are times where it is a very useful tool, and so I like to have that in the toolbox and then not have to necessarily sell that animal, because I don't have very many animals, so every animal I sell has a big impact.
Joe: Brad, I think it's time for your only question, farm question, unless you want to text me one and then I'll ask one.
Bradley: No, I will ask.
Emily: That's cheating.
Bradley: One thing I find interesting about Kevin's farm is his cows have horns and I'm curious why he has decided to leave these horns on cows. I've lots of reasons you're doing some of that here, but you don't see that very often.
Kevin: I have been working on my answer to that because it's hard to explain. The easiest answer is I like horns and I like how the animals look. Initially is because I follow not all, but some of the principles of biodynamics, and in biodynamics horns are seen as an important organ for cows, and it's seen as-- Multiple things, a sensory organ, a digestive organ, and if you know anything about biodynamics, it involves a lot of things having to do with cosmic forces, other unseen things that get into spirituality which we don't need to dive into here, but the horns play an important part in that.
That's where it came from originally my reasoning. I grew up on biodynamic farms, I trained on biodynamic farms in Germany, so I was only ever around horned cows before I got my own ?
cows. That's the only thing I really knew. I guess to add to that, I would say I feel like it's an important part of cow behavior how they interact with each other. Those are all part of it.
I understand a lot of the reasons why one would not want horns. It takes more-- you have to make sure they have enough space, both for cow safety and human safety. Anybody working with animals always should have spatial awareness of where the animals are, but especially with horned animals, it doesn't matter how friendly they are, if they have a fly bothering them, or if another cow is bothering them or whatever, they are not very spatially aware of you or how frail humans are. They aren't necessarily trying to hurt you, but a horn can hurt you very quickly. Just that safety pitch. Horns can be dangerous and I'm aware of that and I try and be really careful around my horned cows.
Bradley: Sure. That's good advice definitely.
Emily: Thank you for the safety comment, Kevin. That really means a lot to me personally.
Joe: That makes Emily feel really good that you're addressing that.
Emily: It really sounds like Kevin you have a lot going on. I think it's so interesting just to hear about, like you said, the unconventional way you got into dairying and using the biodynamics. For some people, that's unconventional. Horned cows, I know you have a lovely mix of breeds and color in your pastures as well. Like I said, there's a lot going on. I feel like we've barely scratched the surface. Making cheese, having pigs, working with your wife. What would you say are some of the biggest challenges that you've faced in your unconventional path into dairying and even through dairying currently?
Kevin: I don't know if you knew this was coming and so you were just lobbing me a softball or what, but mental health, by far, the biggest challenge since I've started doing this full-time. Definitely. There have been a lot of challenges, but by far, the most challenging thing for me has been mental health.
Emily: Yes. I think that's really good that you recognize that. I was expecting, and a lot of people do this, is they'll just give me the laundry list of their stressors. I'm sure you could think of a lot of different challenges. Challenges with having cows with horns, challenges with making cheese, things break down, et cetera, but I think they can all be summed up back to mental health because all of these things take their toll on us as people. I think it's really great that you just went right for it. You're like, "Yes, my mental health is a challenge."
Do you want to share a little bit more about that? I know you share a lot on Twitter about it, which is how I first got connected with you. Seeing you talk about the good days and the bad days and here's a good picture and here's a bad picture. I would love to know a little bit more about how you got into that.
Kevin: I'll start by saying part of why it's more obvious to me I think that mental health is my biggest challenge, is that I have a clear before farming and after farming. Farming has always been a part of my life, but not in the same way as somebody who grew up on a farm, started working on the family farm, and then maybe at some point quit the off-farm job. Depression has been a big problem for me the last five years or challenge. Looking back, I can see where I had some issues with depression before that, but it wasn't in the forefront, it wasn't really as big a problem before.
When it really started to be something that really had to be addressed was back in 2016. That's not when we started our farm, but that's when I had no other off-farm employment. March of 2015 or 2016 was when I stopped managing hogs at a nearby facility. Yes, I have worked in conventional agriculture. I worked in hog confinements for a few years before this. Then September is when we started selling cheese. That fall of 2016, I was milking twice a day at that point. I had a full-time employee, which was part of the business plan, who was doing I think five milkings a week, and some other farm tasks, and that filled up his 40 hours.
We had enough milk at that point that-- This is how I remember it anyways. I was making cheese every other day. I was making two cheeses when I started, and both of them were pasta filata cheeses, which is mozzarella and provolone are both in that category. That means they're stretched in hot water. Both of those processes without going into detail of the cheese make process, essentially, I started at 3:30 in the morning and the earliest I would get done would be the following midnight. My employee would do the evening milking on that day, but it was too much for him to do the following morning. Didn't have enough recovery time. If you can tell, I might harbor some hard feelings here.
I would do that like 18, 20, 22 hour-day. Sometimes I would go till 2:00 or 3:00 in the morning and then I would get up at 5:00 and milk cows the next morning. Then I would go to bed the following evening whenever I could, get up at 3:30 the next morning after that, and do it again. I did that all that fall. Between that and the stress of we were six months behind our marketing plan, so we were already running low on cash. We had like three weeks of market before the market ended, and our plan was to start selling cheese right at the beginning of summer. Instead, we hit the end of summer. We ended up doing a bunch of wholesale and trying to get the cheese buyers to want to buy it.
My life is stressful now. It was 10 times worse then. I feel like that's when it all just really-- Okay, you can be a little bit depressed where you're stressed or feel down some days. If you are really short on sleep, that is going to make it a lot worse. That's when it became a real problem was when I was doing that. That was a bit of a long answer, but you can see how that was a really stressful time where I was also really excited because I was finally living out my dream, but then feeling really bad because it felt like a nightmare. It was at some point at the encouraging of my wife, I tried to see professional help. That was a long process, which we can go into later itself of trying to get the right help and so forth.
I wasn't even on Twitter. Maybe in 2017. I can't remember when I went on Twitter, but I wasn't sharing about the mental health stuff right away. I feel like, for me, it started just one day I was just like I just feel horrible, I feel angry and I feel like the world needs to know that I'm hurting for no particular reason and I just started tweeting about it. At that point, it started out just as venting, and then a lot of people were like, "You're so brave," and things like that and I'm like, "I was just venting and getting it out there."
I think why people don't is because they're afraid of the negative reactions. The closest thing to a negative reaction I've got on social media when talking about my depression and my experiences is people doing the-- and it was done not in a bad way, with bad intentions is when people say, "There are so many people that would love to be doing what you're doing." That sort of comparative thing, which is not helpful. People that have been around mental health they know that. It's something people do and they're trying to help. It's not helpful.
That's the closest to a negative reaction I've had. I've never had somebody say, "Would you you just be quiet with the whining." It's possible that some people that they maybe came on to look at my cow pictures, so that's why they started following me or to watch the cheese making, and they were turned off by it and they left. I don't get to do exit interviews when people stop following me, but I don't think I've lost a lot because of it. Mostly, I've gotten really good feedback. I've made actually some really good connections between Emily. Other people, that have reached out often via direct message, they'll say, "Hey, anytime you want to send me a message--" "Are you okay?" Or they'll just give me their cell phone number and they'll say, "If you need to, call me." Just complete strangers-
Joe: That's pretty amazing.
Kevin: -that just know me through Twitter. They're just like, "I'm here for you if you need to talk. Here's my number. Call me day or night."
Joe: That's really cool. That's pretty impressive that people are willing to reach out with that and I think it's amazing that you can reach out to the world of the internet and we all know how the internet can be sometimes. It can be a pretty harsh place. It's exciting to me to hear that you've had such a good experience with it.
What I wanted to ask you, Kevin, was you touched on it a little bit. You were feeling bad because the thing that you'd been working so hard to do is your dream job and you're not enjoying it, and now you maybe you feel guilty about not enjoying it, and then you're working yourself to the bone with no sleep. Do you realize what's happening when you're doing that, or do you just stretch yourself thin and someone else had to point out to you that it's okay that you're feeling this way? Were you self-aware enough in the moment to know how stretched-thin you were? I feel like I see that in farmers a lot. They're just so used to the daily grind that they don't realize that maybe that's not the way it has to be.
Kevin: I realized that I was stretched-thin, realizing the connection with mental health and that sort of thing. There were a lot of self-awareness things. It's still a journey, but that's a lot of what therapy has been is noticing what is going on and what the feedback loops are.
Therapy is different for everybody. For me, it's not sitting on a couch and talking about my childhood or whatever. It's going through, okay, how are you reacting to when something goes bad when you're in a good mood and you're reacting well, versus how are you reacting when you are feeling depressed and it brings you down even more and you're blaming yourself for it or whatever? Almost picking it apart analytically so that to be more self-aware. A lot of it starts with the awareness and then developing ways of trying to train yourself to react differently. That self-awareness has come with time and it's not easy.
Emily: Following up with that, Kevin, when you were feeling this way and talking about that self-awareness piece, now hindsight's always 20/20. Were there specific things that you noticed started to slip? You talked about not getting enough sleep, but maybe, did you notice you felt angry more, or maybe you were getting in more fights with your wife or yelling at the kids a little more, or just feeling like you couldn't get out of bed some days?
What were some of those things that you noticed that maybe, Renee, your wife noticed and that eventually became a part of you thinking about the self-awareness piece and what are those feedback loops, and maybe what are the signs that I'm not doing well right now because X, Y, and Z are happening?
Kevin: It's a really tricky question to answer because it was all kinds of things happening at once. Renee has been really supportive and she has definitely noticed a lot of things and tried a lot of different ways to be helpful which is not easy. Probably there are somewhere, there needs to be a support group for spouses of depressed people because it's not an easy job.
I guess the biggest thing I noticed was my inability to have, get up and go or gumption. I'm naturally a hard worker. I didn't go into this because I don't like to work. I didn't go into this expecting it was going to be easy, expecting I was going to be able to work 40-hour weeks. I never had that expectation, but I did expect I would be able to sleep eight-hour nights sometimes which I do now, sometimes. Not as much as I would like. I'm still working on that. And be able to do some things that weren't farm related.
Anger, irritability, losing my temper, those things definitely came along with it for me but I think even before depression was a big thing, I think that was something I struggled with, and I didn't make the connection that those things were linked until much later. I think Renee may have. Anger works differently in different people. I guess I should be really thankful that my anger-- I don't get angry with people as much. I don't like conflict but sometimes that can be a problem too, but I get mad at inanimate objects and unfortunately, I get mad at cows. I always kick myself afterwards which doesn't necessarily make it better.
The anger piece has gotten a lot better and therapy has helped with that but I think that is one of the things that I think medication, which is another topic that we may or may not want to get into, but medication has helped with anger piece. That's the piece that it has helped most markedly with and getting medications right is a whole journey of its own that helped a lot, but also therapy and sleep.
Emily: All right. I have one more follow-up question I want to jump into really, really quick, and then I will let Joe ask a question that I know he's chomping at the bit to ask. Kevin, and just keep this answer short. On Episode 1 for our mental health series, we were joined by Dr. Megan King, who has actually done research that suggests that when farmers are in poor mental health, their animals may be in poor health or welfare may not be as high of a priority.
I was just curious if you've maybe noticed that and if you don't want to answer this, you don't have to. Just curious if hearing that makes you think, "Yes, when the cows are better, I'm better, and vice versa." We really talked about it being a two-way street where it's not just human-dependent and not just cow-dependent, but goes both ways. I'm just curious if you have any observations or thoughts on that with your experience on the farm.
Kevin: I guess I will say it's most obvious in the parlor. If you have a bad attitude or a bad mood, the cows will throw it right back at you. Literally, they will kick you more and they will poop on you more. Then on the long-term health aspect, I think it's more just that when my brain is healthier I'm able to make better management decisions and thereby helping all the health outcomes better. Of course, it's hard to know exactly, but that's what I've observed.
Emily: Okay. Joe, I just need an isolated sound bite of when my brain is healthy, my cows do better, or I can make decisions better. I just need that, but that can be a slogan for a future t-shirt or something.
Joe: Sure. I'll pull it out.
Emily: That right there, that sums it up for me.
Joe: Absolutely.
Emily: That's what I want every farmer to hear. Maybe just play that on loop-
Joe: On loop.
Emily: -a couple of times-
Joe: Like an affirmation?
Emily: -on an episode, yes. [laughs]
Joe: I think I'm relating to Kevin a lot right now when we talk about the irritability and the anger. When I've struggled with my own mental health, that has been one of the things I noticed first. The irritability is big. My anger at inanimate objects is through the roof when my mental health isn't straight. I really relate to that a lot. One of the things, Kevin, that I wanted to get into is how you made the step to commit to going to therapy. Take me through that journey just a little bit of like, when did you decide, "Yes, I should go?" Did you have to have someone like your wife say, "You really should go"? How did you go through that decision to actually jump in and commit to therapy?
Kevin: Well, first off, let me say I am lucky that I have a wife who has a full-time job with benefits and health insurance that covers mental health. That has made therapy an affordable option for me. That doesn't mean it's not affordable if you don't have health insurance, but I can't really speak to that. I feel incredibly privileged that I don't have to take that into consideration in whether or not to go to therapy, money is not part of it. I don't even have to do a copay. That is just an incredible privilege.
It definitely was at the urging of my wife to start with. There was probably a year, maybe even two of reading books, talking to friends and relatives and getting suggestions of other people that have struggled with things, and people sending me books and articles and trying strategies on my own before. My wife was like, "Look, we have good health insurance. You need to go see the professionals, this is too big a problem to address just by reading a book, even if it was written by a mental health professional. You need somebody to address your problems specifically, you can't self-diagnose and fix it with diet and exercise," which is basically what I was trying to do.
From that step of saying, okay, we need to see a mental health professional, first, what's available in our area and we're again lucky that we live-- so we're about a half-hour north of Ames, which is not a large city, but it's a city that has a hospital and a large McFarland Clinic system and so forth. We're only an hour from Des Moines, which has even more, and so many people in rural areas would have a lot fewer options or would have to drive further. We had options to look through, do we start with this therapy clinic over here, over there? We essentially drew a name out of a hat of one that looked like it was a good fit that had both therapists and clinicians on staff who could prescribe so we thought, okay, we can go to one place everything that may be needed. Because I went into it, I was like, the first session they have an intake to kind of assess what is it really, what are you dealing with, what do we think we would recommend for you, and then they direct you to-- I'm trying to think.
They didn't have an actual psychiatrist on staff, but they had a nurse practitioner who could prescribe medications, which I guess, my primary care physician could also prescribe. They can prescribe all the things that a psychiatrist can, they just it's not their specialty. They first recommended that I go do a session with the nurse practitioner to go down the medication route, which I was pretty skeptical on at first. I was like, "Oh, I don't want to get all drugged up and start to mess with things that way," but if these guys are the professionals, I'm trying to do the professional route. I'll do what they think is right.
I did not like the nurse practitioner. I do not know where he got his training, but he made comments like, "Well, farmers back in the day used to work, night and day, seven days a week and they never had to take any break." Anybody who has ever heard anything about mental health knows that's a bad thing to tell a depressed person that there are other people that are doing what you're doing or doing it and working harder. That is the worst possible thing to say.
Emily: I would say everybody could have seen our faces because me, Brad, and Joe were all like, "Ooh," when you said that. That's really crappy.
Kevin: It's obvious to his eyes. He prescribed me to-- I don't remember what it's called but an antidepressant. The struggle with antidepressants is that they take a while, it's not like a pain medication that you take it and it takes effect within 20 minutes or whatever. It can take a week or two or three before you really know, and so he prescribed it and he said, okay, we'll have another session in I don't remember what it was, it was a month or six weeks or something like that, and review if we even need to do a different dosage or try a different medication or something like that.
Let me add, this was early February, and February tends to be as for many people who even don't struggle with depression, otherwise, February could be a hard month because there's not much daylight. The weather tends to be gray and it's not like pretty snow. It's like ugly, brown, half-melty snow. I don't need to go into why February is a hard month, but whatever that medication was, it made me super tired, I could hardly move, it made me twice as depressed. I barely made it through that month without committing suicide. That was bad. If I had trusted that provider, I probably would have called them after a week and said, "Look, this is making me way worse." I didn't trust them, and so I was like, "Well, I'm supposed to go through the month." I kept going for a month.
I don't think I had a second session with that guy, I think I just stopped taking it eventually because it was just so bad, and I didn't go back but I ended up going to another therapist at a different place. I saw that therapist for several months. It seemed like it was okay, but I was also getting some, not-great judgy comments from her I felt like and I felt like she just didn't get what I was going through. She didn't understand the whole working seven days a week and a slow day being working eight hours. I don't think she ever got that or me saying that I have a hard time getting up from lunch and I get stuck watching TV. She was like, "Well, people who work at jobs, they can't watch TV at lunch," is like well, "I don't get an evening to do fun things because I'm working 16 hours a day."
Anyway, I stuck with her for several months, and I eventually stopped and so I went then almost a full year without going to therapy. Then my wife was actually going to therapy, not for depression for other issues having to do probably with burnout from grad school. Her therapist actually requested that I come in for one of her sessions to talk about our relationship and my observations of her during the day and things like that. My depression came up while I was there in my wife's session, and essentially that therapist sold me on therapy but said, "We don't recommend that spouses see the same therapist. There's another therapist in our office that I think would be great for you." Before I left that day, I made an appointment with that therapist, and now it's been almost a year and a half I've been with that therapist.
It was not straightforward, "I'm going to go see a therapist. Let me look one up in the phone book, call them make an appointment and start going." I know other people have had even more difficult roads, deciding to go to a therapist is hard. Finding the right therapist is also hard because they're not always going to be the right fit for you. If they're a good therapist, they might recognize that they're not the right fit and maybe recommend a colleague who they think might fit your situation better. Actually, another podcast I listen to which is from NPR, it's called Life Kit. They have one all about how to find a therapist. I wish I had heard that three years ago, but I only heard that a month ago.
Joe: I'll put that in the show notes. I think that's a good thing to do. I don't think I was quite aware of how difficult it could be-- I knew not every therapist was for every person. You have to have a good connection with that person. They have to understand what you're going through. I wasn't aware of how difficult it could be to find the right therapist. Emily, is that something that you have any thoughts on that?
Emily: Something I always say about therapists is finding the right therapist is like shoe shopping. You usually need to try a few before you find the right fit. Sometimes you'll get lucky, but usually not. Like Kevin, I have seen three different therapists and I actually ended up going back to number two because number two had referred me to the third therapist and it just wasn't quite right, I revisited with them about that, and they were able to basically make room in their caseload for me, and I've been seeing that therapist for probably about a year and a half also, Kevin. Yes, it can be difficult and it can be really easy to get discouraged.
Kevin's story is not unlike other farmers I've heard with running into therapists who just don't seem to get specifically the farm lifestyle and that it is seven days a week of work and just taking a long weekend is not really a viable option. I think that that is a big challenge and something that we've been working on and are aware of in the farm and rural stress arena is that like me professionals that's really, really important.
Joe: I find it really interesting that you were able to get medication, Kevin, without finding the right person to talk to. To me, clearly that nurse practitioner was not the right fit and you knew that but that�s the toss-up. Of course, you want to have the right person to talk to when you get the medication but sometimes you need that medication to have like you said, the gumption and get up and go to them, go through that process of trying to find the right therapist so I don't know. Kevin, Emily, thoughts on like, I don't know, I'm just interested in the dynamic of that medication and therapy and then not being able to do both at the same time.
Emily: Well, I think it happens in different ways. Everybody's situation is different, everybody's in road to mental health care is different. Some people start medication first because they may tell their primary care physician, "Hey, I think I'm depressed," or there are certain questionnaires and instruments they can use. The PHQ-9 is one that's commonly used for depression and suicidal thoughts and so a primary care physician can't provide counseling or therapy. They may just go, "Okay, here's medication," and it's done, or they may go, "Here's medication, and we're going to refer you to this therapist."
I was really fortunate that was my situation where my therapist, the one I currently see they're actually integrated into my health care system and so my therapist and my doctor can both see my chart which is really useful since my therapist cannot prescribe medication but they can still communicate about that. Anyways, and then where some people and that was where I started that I went to therapy first. Again, I saw a licensed therapist but they weren't a nurse practitioner, they could not prescribe anything. They recommended, "I think you should talk to your doctor and you can tell them that I said, this would be my recommendation, but they're the doctors so they can decide what they do."
That was really useful too. I just got really lucky and that was for my first therapist just that I had that guidance from them of what to say to my doctor and what would work for me or what they thought might work. My experience with it is it just happens so differently for everybody. There are sometimes situations where if it's not a physician's area of expertise it's just, oh, here's medication and go on your way. For some people that works, and for some people, it doesn't. For some people, it's just therapy and they don't need medication and that works. For some people like myself, like Kevin, it's a combination of both and that's what comes together to make it work.
The most important thing is, we all need to share our stories about mental health I think because they're all different, and everybody experiences it differently but we will still have some similarities. Like we were saying last week where we're not all in the same boat but we're on the same ocean so we can navigate these waters together. Kevin, I'd be curious to hear what you think on this as well.
Kevin: I actually had a really similar experience to yours. I had that first nurse practitioner that didn't work out and then I had been skeptical of the medication route from the start and that reinforced that. Then I went to see a therapist but then it was actually that first therapist that didn't work out who after several sessions was like, "I think we're having trouble working on the things that we need to work on in therapy because your depression is pretty major. So if you can see a prescriber of some kind then maybe the medications can bring that depression level down to a manageable level where maybe we can work on some strategies through therapy so that the medication alone isn't going to just get rid of it."
Like you said, for some people that might just work like magic. Most people probably it's not magical but occasionally it might. She actually referred me to a psychiatrist who has her own practice in Ames and so I was able to get it but she had a several-month waiting period. I actually got in and so I'm still seeing the psychiatrist, not as frequently as therapy but every couple of months. We think we've got the right combination of meds right now but we're still seeing if we need to make tweaks of dosages or timing or whatever. It's hard and it took a couple of years, even working with a psychiatrist who this is what they do, this is her specialty to get to that point, and that can be very frustrating.
The other part I want to touch on is just finding the time to go to these appointments it's exhausting and it's hard. When we got to the point where I realized I needed to seek professional help it was like the success of our business depends on me getting better because this is going to fail if I don't get better, and so we need to make time. It is an essential part of work. It's still hard to make the time. You know what? Honestly, during this pandemic, insurance will pay for telehealth and so how you can do it from home and so I don't have to take the time to drive to town. That is huge but at the end of June, that's going to run out.
I don't know why insurance providers won't pay for it regularly. I don't understand especially something like therapy or even psychiatry where there isn't anything about physical presence that is more beneficial necessarily. But for somebody like me who leaves early and has a really busy work life making the time 40 minutes to drive there plus park, walk into the building, do the appointment, walk out and drive, it's taking several hours out of my day and that's hard to find several hours. I've really liked the telehealth but we're going to have to find a way to make that work again in July.
Joe: Yes, we�re going to have to put Emily on that. Let�s stick her around that problem about telehealth being covered [crosstalk].
Emily: Working on it. I did want to make a point, Kevin, about how you were talking about getting the dosages of medication right but still going back and visiting with your psychiatrist every few months. That's what I say to people too is the goal I think for everybody involved in this whether it's your physician, a therapist, a psychiatrist, et cetera, is to get you to that point where all you need is just-- I compare it to routine maintenance like on your car. If you take your car in for an oil change, they run diagnostics. Same thing, take yourself in, how are things working? Is everything going well? What could we maybe change? What seems to be causing issues that wasn't last time?
I think it's really important that you said that. I'm really glad that you brought that up because I think that that's a really important piece of it, and it's not, "Oh, I got this prescription once I'm good to go for the rest of my days," or "I went to therapy, but I feel better now so I don't need to go back." We need to keep up with ourselves and keep up with our mental health just like how we go and get physical checkups. We're supposed to get a physical every year, I'm not sure everybody does. Anywho, my point is just making sure that you stay with it and that you don't ignore it again. I think that that's a really important point that you have made as well. We are running low on time here so I'm curious Bradley or Joe, any other questions?
Joe: One of the things I've been thinking about since we started this series is-- and Kevin addressed some of it with the questions and the comments he was getting from some of the initial people that he saw. I feel like what I've seen play out when I was in practice and visiting farms is that there is this guilt that comes to farmers when they feel like-- It's completely unrealistic for Kevin to be working 22-hour days, sleeping almost nothing, and then getting up and milking and doing it all again, that's completely unrealistic. There's a feeling of guilt I feel like because people expect farmers to be the pillars of society, and they've always seen them as just rock solid and working hard and that's just expected. In my mind, it's not fair, but there's a lot of guilt that comes with that feeling when people are like, "You're supposed to be the hardest working person of all of us and you're breaking down." Can both Emily and you, Kevin, can you just talk about that feeling that might creep in, that guilt?
Kevin: Guilt is a huge, huge part of that. They talk about negative self-talk is a lot of what therapists talk about, and guilt that you place on yourself is a big part of that and it's a hard one to overcome. It's what I often call-- my therapist gives me mental gymnastics to do. That's what it feels like because you're having to build new habits mentally, that's the tough thing. You have to use your brain to fix your brain.
Even a couple of episodes ago, you guys had somebody on who's just an amazing person who does-- I don't remember his name. He was a radio host and he does hog sites and he manages his beef feedlot and he works out for an hour every morning. I was listening to that like, "I should just be in awe of this person who can get by like that and just be like "Wow, that's cool that he can do all that stuff," but instead, my brain goes to, "Well, shoot, I guess I'm not actually that hardworking." That's where my brain automatically goes. Where the therapy kicked in then is the fact that I noticed right away that I did that. I was like, "I'm feeling guilty."
I still felt guilty, but I noticed that I was feeling guilty and that I shouldn't feel guilty, and that I was just comparing myself to somebody that we're all different. Some people need six hours of sleep, some people need nine, just as an example. Comparing yourself to somebody else is a fool's game. Dealing with the guilt, it's an ongoing challenge to stop feeling guilty. It's also hard because there is no such thing as being a perfect farmer because there's always more you can do. There's always something you could have done better or some job you could have done a little bit more perfect. So being okay with knowing that you are doing a good job or even not feeling bad about the 100 things I'm not doing, knowing, "I set a priority that today I need to do this job. It's okay that I'm only doing this job because I'm only one person, I can only be in one place at a time, and I am doing the job that is the most important right now." To remind myself of that and not to let my mind go to the 100 other things.
Emily: I just have a couple of points I'm going to add, but first, I'm going to say, Kevin, you should write a book. I've written down so many things you've said today because they're just brilliant.
Joe: Yes. Me too.
Emily: What I want to say in follow up to what Kevin was saying, first is, yes, comparison is the death of confidence. I think it's important to remember, like Kevin was saying that everybody is on their own journey, everybody has their own thresholds and there's usually a lot going on with people that we are unaware of. Part of why we're having these conversations this month.
The other thing that I would say as far as the guilt or feeling like, again, you're not keeping up or comparing yourself to others, and this is the mental gymnastics that I get from my therapist, kind of an ongoing theme because it just kept coming up in sessions was the concept of both/and where at the very beginning, Kevin, I was going to say this, "[unintelligible 00:54:27], right now we're farming." It can both be your dream and it can be a nightmare some days.
These things, thinking everything exists singularly in a vacuum, that's not the way the world works. A lot of it is dichotomies or even more than that. It's both/and. It's light and dark. I think that that-- I know for me has been a really important thing that I've learned in therapy and has been part of my ongoing homework that I get is when I am feeling down or feeling guilty, especially, think of it as a both/and like, "Yes, I can both be happy with a certain situation and I can be frustrated by it." Or it's like, "Oh, yes, I love my job and I do. I'm both in love with my job and I have days where it's just really exhausting and I'm just like, "Ugh." That's totally normal.
I'm really glad that you spoke to that, Kevin. We are getting about closing in to wrap, so I'm just curious, Kevin, is there any other points you wanted to make, something you were really hoping we'd ask you about today, but didn't? Any last message you want to share with us and with our listeners?
Kevin: No. I just want to thank you guys for having me on. Thank you for having a wonderful podcast. I subscribed and I always listen to it while I'm milking cows. Even when you're talking about things that apply mostly to bigger confinement dairies or to managing employees and setting systems or whatever, it always gets me thinking and thinking about improving my management, so thank you. Thank you for doing a wonderful job, and thank you for having me on and asking good questions.
Emily: Thank you for that glowing review, Kevin.
Kevin: Yes, thank you.
Emily: Like I said, Kevin has been one of our early listeners. We're so excited that he's gotten to be on the show with us now. Before we wrap and do some plugs, I want to give a huge shout-out and thank you to Kevin's wife, Renee. I know that it is not easy to be a partner to somebody in crisis or that has struggles with their mental health. You touched on that, Kevin. It can be tough for them and I think it's so great that you recognize that. Like I said, I just want to give her a shout-out because she is phenomenal. I love seeing her pop up on Twitter every now and again too. I know that she does a lot on the farm as well. I think it's so great that she was the one to really help connect you to getting help in the first place. Shout out to Renee for sure.
Kevin: I will pass that on and I'll make sure she listens to this episode.
Emily: Yes.
Joe: Perfect.
Emily: We talked about her a lot. She's great. With that, questions, comments, I don't think I'm going to accept scathing rebuttals about this episode, but if you have anything you want to say, you can always email themoosroom@umn.edu.
Joe: That's T-H-E-M-O-O-S-R-O-O-M @umn.edu.
Emily: You can find Kevin at Lost Lake Farmer on Twitter, on Instagram, and on TikTok. Lots of great content, so be sure to check him out there. If you were interested in learning more about the farm and checking out their online cheese shop, you can visit lostlakefarmllc.com. There you go. Lots of things to follow, but yes. Thank you again, Kevin, for being on. This was an outstanding episode. Great conversation. I know I really learned a lot. I'm very appreciative of your willingness to share your story and to put up with the three of us for far too long. We will see you next week, everybody. Bye.
Bradley: Bye.
[music]
Emily: This is my world. You are just living in it.
Joe: That's true.
Bradley: You guys are so cute.
Joe: She is wrong every once in a while when she thinks-
[00:58:39] [END OF AUDIO]

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