Holding It Together (Kinda)

Michael Mackniak, Esq

Here we will get real in our conversations about Mental Illness and Caregiving, and the messy reality of keeping it all balanced.

No sugar-coating, no clinical jargon—just real talk about the hospitalizations, the medication battles, and the toll it takes on a home

This is for the parents, siblings, and partners who are doing the impossible every single day.

Holding It Together is a home for the overthinkers, the multitaskers, and anyone who feels like they’re one spilled coffee away from a meltdown.

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22 episodes
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Avg 57 min
English

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S1 · E31
Thursday · 1 hr 2 min
Justin Ray: Hospitals Without Walls
Send us Fan Mail The scariest part of a mental health crisis is not the diagnosis, it is the moment you realize the system can see the problem and still tell you it does not qualify. Justin Ray, a board-certified psychiatric nurse practitioner and 22-year retired Navy veteran, joins us from the trenches where hospitals, jails, families, and community care collide. We talk honestly about what happens when someone is psychotic, homeless, or cycling through repeated ER visits, and why “not sick enough” can be the most dangerous label of all. We break down Assertive Community Treatment (ACT) as a true “hospital without walls,” built for people who cannot reliably come to an office because of severe mental illness, poverty, no transportation, or disorganization. Justin explains what ACT teams do day to day, why deinstitutionalization without adequate funding pushed care into emergency rooms and correctional facilities, and how burnout grows when the work becomes nonstop crisis management instead of real recovery planning. Then we go where most conversations avoid: leverage. We discuss outpatient commitment, forced treatment in inpatient settings, and the reality of anosognosia, when someone genuinely cannot recognize they are ill. Justin shares a case that shows the gap between hospital orders and community follow-through, plus the medication side of the story: long-acting injectables, clozapine’s risks and benefits, and promising new directions in schizophrenia treatment that may reduce side effects over time. If you are a family member, clinician, or advocate trying to keep someone safe, this conversation gives language, context, and practical ways to collaborate across broken handoffs. Subscribe, share this with someone who needs it, and leave a review with your biggest question about fixing mental health care. Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&sprefix=mackniak%2Caps%2C305&sr=8-2 If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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Wednesday · 9 min
Episode 1 Companion: Six Hospitals Later And Everyone Still Acts Surprised
Send us Fan Mail Six hospitalizations in nine months can look like “care,” yet still leave a family right where they started: scared, depleted, and forced to explain the same story to strangers who only see a single moment. We slow things down and unpack the foundation behind “Six Hospitals, Two States, Nine Months,” the episode that set the direction for our work on family mental health, caregiving, and fixing the gaps in psychiatric hospitalization and discharge planning. We talk about the brutal pattern that shows up in crisis systems everywhere: movement without continuity. Each unit, ER, or evaluator gets a snapshot, while families live the full arc at home. That’s why we built a free companion guide to help you create an airtight crisis timeline with exact dates, observable changes, and safety events, so you can turn months of chaos into one readable story. We also dig into “snapshot versus the arc” and the line we want every clinician to take seriously: one calm hour should not erase a year of crisis data. Finally, we walk through how to use that timeline to build a continuity packet that crosses every door, separate facts from assumptions, and pressure-test a discharge plan before it fails on day two. If you’re supporting someone through severe mental illness, repeated admissions, or an endless cycle of handoffs, this gives you practical traction without adding more “homework.” Grab the free companion guide in the podcast description, then subscribe, share this with one person who needs it, and leave a review so more families can find these tools. https://michaelmackniak.org/free-listener-action-guides Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E7
August 27 · 1 hr 11 min
Communication and the Cost of Silence
Send us Fan Mail A single missed conversation can be the most dangerous part of treatment. We start with David, a 62-year-old man living with schizophrenia who is stable on a complex antipsychotic regimen until an urgent care visit adds the wrong sedative. His family tries to warn the provider about medication interactions, gets blocked by privacy talk, and the outcome is catastrophic. It is a brutal reminder that care coordination between psychiatry, primary care, and emergency medicine is not optional when severe mental illness is in the mix. From there, we get concrete about why this keeps happening: the “unreliable historian” problem, anosognosia, rushed appointments, and electronic health records that still do not travel cleanly between systems. We share what actually helps families in real time, including keeping a current paper medication list, building a simple timeline of hospitalizations and placements, and learning when to escalate with names, dates, and documented calls. We also dismantle a common misunderstanding about HIPAA and patient privacy: even when a clinician cannot disclose information back to you, they can often still receive critical information from you, and that “one-way street” can save a life. We close with practical communication tools that reduce blowups and increase honesty, like half-and-half meetings that let caregivers speak freely before bringing a loved one in, plus a focus on patient-centered care that meets paranoia and delusions with curiosity instead of dismissal. If you’ve ever felt like you were shouting into the cracks of the system, you are not alone, and you are not a liability. Subscribe, share this with someone who is caregiving, and leave a review so more families find it. What’s the hardest barrier you’ve hit when trying to share information with a hospital or clinic? If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E17
August 20 · 1 hr 2 min
When The Doctor Becomes Family with Dr Mohamed Elziam
Send us Fan Mail A white coat can make people think medicine is all control, clarity, and clean answers. Then a crisis hits your own family, and you learn how fast that illusion collapses. We sit down with Dr. Mohamed Elziam, a family physician, to talk about his brother’s late-onset schizophrenia and what it’s like to live in two roles at once: the clinician who understands diagnoses and pharmacology, and the brother who is grieving, advocating, and trying to keep everyone safe. We get specific about the mental health system problems families run into every day: symptoms that get dismissed as “drug-induced,” discharge plans that assume motivation and capacity, and a fragmented pipeline where nobody owns follow-through once the patient leaves inpatient psychiatry. We also dig into the realities of schizophrenia and anosognosia, where medication noncompliance is not simple stubbornness, and where repeated decompensations can change a person’s baseline over time. Dr. El Zin shares why long-acting injectable antipsychotics can be a turning point, and why getting there often takes more persistence than families should ever have to provide. We also unpack HIPAA and patient privacy, including the common misunderstanding that clinicians cannot even listen to family context. That myth creates silence where there should be collaboration, and it fuels caregiver burnout. If you’re supporting someone with severe mental illness, this conversation offers language, perspective, and a clearer map of the traps built into the system. If the story resonates, subscribe, share this with someone who is caregiving, and leave a review so more families can find these tools and feel less alone. Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&am If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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August 13 · 46 min
Elder Care Is A Life Plan with Shanika Batchelor
Send us Fan Mail “A nursing home” is one of the most emotionally loaded phrases in caregiving and it often shuts down the real conversation we need to have. We sit down with Shanika Bachelor, founder of Armana Assisted Living in Egypt and co-founder of an assisted living operation in Wisconsin, to rethink what long-term care can look like when dignity, autonomy, and community come first. We dig into the practical side of elder care and senior living, including the clear differences between small group homes, assisted living, and skilled nursing facilities. Shanika explains why memory care for Alzheimer’s and dementia is becoming essential, and how the best communities reduce disruption by letting residents step into higher support without losing their familiar environment. We also talk about couples aging together, and how assisted living can keep partners close even when one person needs dementia care. Then we zoom out to the big forces reshaping everything: caregiver guilt, the mental load of managing meds and appointments, a more transient population living far from parents, and the rising cost of care in the United States. Shanika shares why Egypt and the broader Middle East and North Africa region may be ready for a new assisted living model, and why “luxury” often means basics that should be standard: calming design, good lighting, meaningful activities, and spaces that feel human. If you’re planning for aging parents or for yourself, hit play, share this with a sibling, and subscribe. After you listen, leave a review and tell us: what would make long-term care feel less scary and more like a real life plan? Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&spref If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E3
August 6 · 58 min
The Dilemmas of Addiction
Send us Fan Mail We explore the hard edge between autonomy and suffering through Jamie’s story and the wider reality of co‑occurring addiction and mental illness. We ask when saving a life becomes enough, how families hold the line, and why systems confuse stabilization with success. • co‑occurring disorders shaping addiction and depression • families as first responders at the front line • the broken safety net after detox and discharge • autonomy versus intervention and stages of change • stigma, neuroscience, and reframing addiction as brain disease • commitment laws, beds, and practical barriers • ACT teams, navigators, and continuity of care • boundaries, culture, guilt, and self‑care for families • guardianship limits and realistic expectations • redefining success beyond survival toward quality of life Find us on YouTube at HITKINDA and subscribe. Like, follow, comment, vent, throw rocks, tantrum, whatever you need to do today, but please follow us If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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July 30 · 59 min
The Great Earwax Contraband Caper with Jolene Breinig
Send us Fan Mail Caregiving gets called a “labor of love,” but that phrase can hide the bruising reality: the physical work, the mental load, the split-second decisions, and the guilt that keeps families trying to do it all alone. We’re joined by RN Jolene Breinig, a home health nurse who works at the intersection of medical necessity and personal connection, to talk about what caregiving actually looks like day to day and why dignity matters as much as any task list. We dig into why families seek out smaller, consistent home care instead of large rotating agencies, especially when dementia care or Alzheimer’s makes unfamiliar faces feel threatening. Jolene explains what she’s seeing in the field, including the rise of “PCA” staffing with minimal training, and what families should look for when hiring help: bravery, patience, empathy, communication, and documentation that doesn’t leave doctors and loved ones guessing. We also talk about the messy part nobody wants to admit: sibling conflict, resentment, and the quiet pressure adult children carry when they believe they “should” be able to handle everything. Then we go straight at caregiver burnout and compassion fatigue, including the red flags that show up before you crash, and the coping tools that help regulate your nervous system when the day keeps coming at you. We connect the dots to the bigger system too: long-term care costs, memory care reality, and why better care coordination and simple tools like a caregiver journal can keep everyone on the same page. If you’re supporting an aging parent, living the long-distance caregiver life, or trying to keep your own cup from running dry, this conversation is for you. Subscribe, share it with a caregiver who needs relief, and leave a review with the one boundary you’re committing to this week. If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E12
July 23 · 1 hr 2 min
The Future Proof Parent: Special Needs Planning Without Panic with Rebecca Iantuonni
Send us Fan Mail The scariest caregiving question isn’t medical. It’s the quiet one that shows up at 2 a.m.: “What happens to my loved one when I’m gone?” I sit down with my friend of 40-plus years, attorney Rebecca Iantoni, to make special needs planning feel human, doable, and real, not like a pile of legal forms you will “get to someday.” We talk about the fragile “house of cards” so many families build with public benefits like Medicaid, SSI, housing supports, and waiver programs, and why a single windfall inheritance can accidentally knock it all down. Rebecca explains Medicaid waivers in plain English, why private insurance doesn’t always replace state resources, and how to move past analysis paralysis by taking “small clicks” across life stages like age 18 decision making, transition planning after high school, employment supports, and community life. Then we get into the practical tools: how a special needs trust is designed to supplement benefits, why purely discretionary distributions help protect Medicaid eligibility, and how a letter of intent can capture the details a future caregiver will desperately need. We also cover funding strategies like second-to-die life insurance and retirement account planning in a post-SECURE Act world, plus a blunt conversation about siblings, boundaries, and why family trustees should take a fair fee to prevent resentment. If you’re a parent, sibling, guardian, or caregiver trying to balance love with logistics, this one will give you a starting point you can act on today. Subscribe for more, share this with someone who needs it, and leave a review. After you listen, what’s the very first “small click” you’re willing to write down? If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E10
July 16 · 1 hr 3 min
Understanding Hoarding
Send us Fan Mail A home packed with newspapers, dogs, broken toasters, or “valuable” scraps can look like a simple cleanup problem until you hear what the objects mean. Hoarding isn’t a character flaw, and it’s rarely about laziness. For many people, a pile is a memory system, a shield, or a last connection to someone they lost and trying to remove it can feel like real physical pain. Michael sits down with Angela and Stephanie to unpack what hoarding disorder actually is, what it isn’t, and why it so often shows up alongside depression, ADHD, anxiety, OCD, and even dementia-related changes. We walk through the patterns we see on the ground: how one room quietly spreads to the whole house, why “files vs piles” can paralyze decision making, and how acquiring can create a dopamine hit that temporarily relieves stress while making the problem worse over time. We also talk about the hidden casualties, including spouses and kids who feel like strangers in their own home. Then we zoom out to the safety and systems side: fire hazards, pests, Section 8 inspections, blight complaints, and the blunt force of housing court and forced cleanouts. We explain why dumpsters can clear a hallway without solving the cause, and what helps instead: harm reduction, safe pathways, coordinated teams, and evidence-based treatment like cognitive behavioral therapy and exposure work built on trust. If hoarding is touching your family, you’re not alone and you’re not crazy for feeling exhausted. Subscribe, share this with someone who needs it, and leave a review so more caregivers can find these conversations. What part of hoarding feels hardest to talk about in your home? If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E9
July 9 · 1 hr 9 min
All the Wrong Doors
Send us Fan Mail “No wrong door” is one of the nicest promises in mental health policy. It’s also the line that can break you when you’re living the reality: months-long waits, intake appointments that lead nowhere, referral lists that are outdated, and a loved one who keeps getting discharged back home while you’re told to “just make some calls.” If you’ve ever felt like the door is there but your hand can’t find the handle, we made this one for you. We talk through what we call the loop of despair and why a system that’s meant to be a safety net so often becomes a labyrinth. With Sara and Stephanie, we get specific about what actually helps families navigate social services and mental health care: asking about openings before repeating your whole story, matching the right level of care to the right need, and pushing for real discharge planning while someone is still inpatient. We also dig into system overload, why care turns reactive, and what happens to the people stuck on the edge between “not sick enough” and “too complex.” Then we get into the practical power moves that don’t require you to burn bridges: document everything, set boundaries, become a respected ally to the team, and escalate up the chain when apathy or misinformation becomes a pattern. We also explain the probate court pivot, including how a court-appointed attorney can help unlock action when you’re truly stuck. We end with the balance that keeps you in this for the long haul: proactive advocacy paired with real self-care. If this helps, subscribe, share it with someone who’s carrying too much, and leave a review so more families can find us. If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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July 2 · 57 min
Set Boundaries And Still Love Them with Dr Michelle Sherman author of Loving Someone with Mental Illness
Send us Fan Mail Your loved one can be struggling in plain sight, and somehow the whole family learns to whisper about it. We sit down with clinical psychologist Dr. Michelle Sherman, author of *Loving Someone with Mental Illness or a History of Trauma*, to talk about the hidden workload of family caregiving, the silence that grows around stigma, and the very real barriers in the US mental health system that keep people from getting support early. We get specific about the emotional side too: ambiguous loss, resentment, and the grief of watching a “new normal” take shape. Dr. Sherman brings a research grounded view of psychosis outcomes and a recovery framework that doesn’t sugarcoat relapses but refuses to label anyone as permanently “gone.” We also talk about how to hold hope when you can’t feel it for your loved one, and why it still counts to build hope for yourself. Then we turn practical: how to show up to short psychiatry appointments with a tight list of facts, how to advocate without getting dismissed, and why relationship and listening have to come before any hard conversation about hygiene, meds, or daily functioning. We also name the siblings and kids who become invisible in these families, and what support can look like for them. Finally, we tackle boundaries and red lines, including what to do in acute crisis when safety is at stake and the only priority is getting yourself and your family safe. If you’re a caregiver, a partner, a parent, or a sibling trying to hold it together, this one gives you language you can use today. Subscribe, share this with someone who’s carrying it quietly, and leave a review with the boundary or tool that helped you most. Guest Info “Loving Someone with a Mental Illness or History of Trauma: Skills, Hope, and Strength for Your Journey” (Johns Hopkins University Press, 2025) “I’m Not Alone: A Teen’s Guide to Living with a Parent Who Has a Mental Illness or History of Trauma” (2nd edition, 2024) - there are SO few resources for these teens! Both books strive to build resilience by providing information, practical skills, and resources. They differ from other books as we merge facts and actionable strategies with reflection questions, activities, and stories from adults and teens with lived experience. You can see the Table of Contents, sample chapters, and other resources on our website. Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&sprefix=mackniak%2Caps%2C305&sr=8-2 If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E11
June 25 · 1 hr 9 min
Caregiver Stress Reset with Alicia Feller
Send us Fan Mail Your shoulders are up near your ears, your jaw is locked, and you are running on adrenaline again and calling it “fine.” If that sounds like caregiving life, you are not imagining it and you are not weak. I’m joined by Alicia Feller, LCSW and former Department of Mental Health executive, to get specific about the physical toll of caregiver stress and the smallest moves that can bring your nervous system back from the edge. We break down what chronic stress does to the body over time, why the fight flight freeze response keeps firing even when the “threat” is paperwork, phone calls, or constant uncertainty, and how modern overload from news, notifications, and social media keeps us stuck in survival mode. Alicia shares simple daily check-ins, a powerful rule for mornings (hint: your phone can wait), and breathwork strategies like box breathing that you can do in minutes, not hours. We also dig into practical tools that meet you where you are: mindfulness as five-senses awareness, mindful eating when you cannot find quiet, sensory grounding with music, and how aromatherapy and essential oils can support relaxation or energy. We talk gratitude journaling as a brain-training practice, why self-care is not selfish, and sleep hygiene basics like reducing blue light and building a calmer bedtime routine when your mind will not shut off. If you are carrying the mental load for someone you love, pick one tool and try it today. Subscribe, share this with a fellow caregiver, and leave a review so more people can find stress management help that actually fits real life. If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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June 18 · 44 min
Make The Strawberry Bunny Then Eat It with Kathy Micheel
Send us Fan Mail Caregiving can look heroic on the outside while you’re shaking behind the safety gate on the inside. We name that gap and get honest about the cost of trying to be endlessly patient, present, and “fine” while managing chronic illness, mental illness, appointments, meds, and the constant emotional load. For us, the real breakthrough is accepting a truth most caregivers were never taught: self-care is not self-indulgence, it’s the fuel that makes you competent, steady, and able to lead your family through chaos. I’m joined by coach Kathy Micheel, founder of Today Forward Consulting, whose approach blends health, life, business, and genealogy into one connected roadmap. We talk about building real bandwidth through the basics that actually move the needle: nutrition, Exercise, Water, Sunshine, and Sleep. Kathy shares a simple campfire metaphor for keeping your energy from crashing, plus practical ways to create “white space” and add small moments of fun when you feel like you have no time at all. We also touch on why baselines matter in healthcare, what your body is trying to tell you, and how tiny daily choices stack into better sleep and clearer thinking. Then we go somewhere unexpected: legacy. Kathy explains how family stories, meaningful photos, and shared meals can help caregivers remember who they are, not just what they do. We also explore when heritage turns into “head trash,” and how to keep what strengthens you while forging your own way forward. If you’re carrying a lot right now, this one is a reset for your mind, your body, and your sense of self. Subscribe, share this with a fellow caregiver, and leave a review with the one habit you’re ready to protect starting today. Todays Guest: Kathy Micheel To connect with Kathy and gain access to caregiver support tools, resources, and upcoming events, visit https://TodayForwardConsulting.com. As a special resource for listeners, her Holding It Together (Kinda) Podcast Bullet Point PDF is available at: https://TodayForwardConsulting.com/HoldingItTogetherKinda Kathy also hosts a Virtual Caregiver Retreat, designed to help you rest your mind, body, and soul, so you can reset, refocus, and step into your next season with intention. Every 90 days, you will feel a shift. If you’re ready to take your next step, schedule a complimentary 15-minute call at: https://todayforwardconsulting.com/book-a-call Her mission is simple: to help you honor where you’ve been, embrace where you are, and confidently step into what’s next. To go deeper into Kathy’s reflections and hear more in response to Michael’s questions, connect with Kathy at: https://TodayForwardConsulting.com/HoldingItTogetherKinda Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Colaition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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June 11 · 1 hr 12 min
Is This Mushroom Edible with Emerson Kerr
Send us Fan Mail AI is everywhere right now, and the noise makes it easy to assume one of two extremes: either it saves healthcare or it destroys it. I sit down with Emerson Kerr, a longtime sleep medicine leader and C-suite executive at Nox Medical, to talk about a third path where AI supports clinicians and caregivers while the human touch stays in charge. We dig into what “precision medicine” can actually mean on the ground, how large datasets can surface patterns no person could realistically see, and why that should lead to better options rather than cookie cutter treatment protocols. We also get real about the risks: confirmation bias, bad training data, and automated decisions that remove the human check that patients still need. Emerson shares why advocacy matters when the system is rushed, including how sleep disordered breathing can look different in women and how that can change testing and care. Then we turn the lens to caregivers and sleep. We break down sleep architecture in plain language, why deep sleep supports physical recovery, why REM supports mental recovery, and why fragmented sleep can leave you wiped out even after “enough” hours. We connect sleep to mental health, including depression and PTSD, and explain why untreated sleep apnea is more than snoring, it can repeatedly trigger fight-or-flight stress through the night. We also cover home sleep testing, wearables, and emerging alternatives to CPAP so you can have a smarter conversation with your care team. If this helped you rethink AI, sleep, or caregiver burnout, subscribe, share the episode with someone caring for a loved one, and leave a review so more people can find it. What part of your sleep routine would you change first? Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_ If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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June 4 · 55 min
Why Your Brain Wants Jelly Beans with Dr Matthew Galati
Send us Fan Mail Your brain is not a fixed object, and neither is your future. I sit down with Dr. Matthew Galati, a family medicine and rehab physician who also survived a severe traumatic brain injury after a brutal car crash. He spent days in a coma, woke up unable to talk or walk, and had to relearn basic skills from the ground up. Then he did the thing the “experts” warned might never happen: he returned to medicine, finished his MD, and turned his recovery into a framework that helps other survivors and caregivers find real traction. We get specific about what traumatic brain injury recovery feels like in everyday life, especially the symptom families often miss: cognitive fatigue. We talk pacing, preemptive rest, and why the brain can burn through energy on tasks that used to be automatic. We also dig into mindset and hope as the foundation for resilience, plus the importance of listening to the patient experience when medicine only sees a short snapshot. From there, we break down neuroplasticity in plain English, including neurogenesis and the role of aerobic exercise and BDNF. Matthew walks me through the Brain Changes Initiative “six pillars of brain health” that support brain recovery and long-term cognitive health: exercise, cognitive stimulation through new learning, brain-healthy nutrition, sleep hygiene, limiting harmful exposures (from alcohol to pesticide residue), and mindfulness meditation and stress management. If you’re a caregiver living with a new normal, you’ll leave with clear ideas you can try and a better way to understand what’s happening inside the healing brain. Subscribe for more conversations like this, share this with someone who needs hope, and leave a review so more caregivers and survivors can find us. What’s one small brain-healthy change you’re willing to start this week? Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2Ijo If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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May 31 · 55 min
Caregiver Misconceptions with ("Host") Victoria Cuore
Send us Fan Mail HIPAA gets thrown around like a brick wall, guardianship gets sold like a silver bullet, and families get blamed for not having “the right paperwork” while they’re actively in crisis. We slow all of that down and get specific about what’s true, what’s hype, and what actually helps when you’re trying to protect someone you love during a mental health emergency. Michael Mackniak and Victoria Cuore unpack five common misconceptions that show up in real hospitals, real courtrooms, and real family phone calls. We talk about why mental illness can’t be treated like a broken bone, why finding the right medication plan often takes time, and why an evaluation done after someone is sedated can miss the reality of who they are at baseline. If you’ve ever watched staff make decisions based on the worst five minutes of your loved one’s day, this conversation gives you language and tactics to push back without escalating the situation. We also tackle the HIPAA confusion head-on. The big takeaway: providers may not be able to disclose details to you, but they can still listen while you share critical information. We even give you a simple two-line script you can use on the phone. From there, we get into the legal side: what a lawyer is ethically required to do, how courts are shifting toward a capability-first approach, the difference between guardianship and conservatorship across states, and why a fiduciary usually can’t “force” treatment the way families assume. If this helped you feel more prepared, subscribe, share it with a caregiver who needs it, and leave a review so more families can find practical mental health caregiving support. What part of the system has been the hardest for you to navigate? Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&sprefix=mackniak%2Caps%2C305&sr=8-2 If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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May 28 · 52 min
A Daughter’s Guide To Dementia and Caregiver Burnout Recovery
Send us Fan Mail Silence is one of the cruelest parts of caregiving. When a parent has cancer, people show up with food and texts. When dementia or a mental health crisis blows up your family’s “normal,” the support often evaporates and you’re left holding the paperwork, the fear, and the grief that starts long before a funeral. We get into that reality with Karmen Jenkins, a retired licensed clinical social worker, military veteran, and life coach who has lived the daughter-to-caregiver role reversal firsthand. Karmen walks us through what long distance caregiving actually looks like, from coordinating doctors by phone to slowly taking over banking, appointments, and end-of-life planning. We talk about the moment distance stops being possible, the strain of moving a parent into your home, and how kids and spouses absorb the shock differently. She shares what helped her navigate services with limited resources, including starting with the Department of Social Services, connecting with aging agencies, and being honest about what you can and cannot afford. We also go deeper than logistics. We name the guilt, the marriage friction, the safety scares, and the disorienting grief of loving someone who is still here but no longer fully themselves. Karmen shares how community support can work when you ask for specific help, and why “holding it together kinda” is not failure, it is the human condition. If you’ve ever felt invisible as a caregiver, you’re not. Subscribe, share this with someone in the thick of it, and leave a review so more families can find these stories and practical tools. Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&sprefix=mackniak%2Caps%2C305&sr=8 If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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S1 · E5
May 21 · 1 hr 9 min
The Cloak of Client Choice
Send us Fan Mail A locked door, a hoarse voice saying “go away,” and a body on the brink of failure. We dive into the harrowing gray zone where autonomy meets danger and ask a hard question: when a mind is hijacked by illness, is “client choice” really a choice? Using Anne’s near-fatal refusal as the anchor, we unpack how good intentions and recovery-language can morph into paralysis, leaving providers frozen on porches while symptoms take the wheel. We bring multiple vantage points into focus: lawyers bound to advocate for expressed wishes, conservators obligated to act in a person’s best interest, clinicians weighing risk with incomplete information, and families caught between fear, hope, and burnout. Along the way, we trace larger system currents—deinstitutionalization without adequate funding, rigid protocols that prioritize liability over lives, and courts that often see only a moment in time instead of the full arc of a case. You’ll hear companion cases that sharpen the stakes: a woman spared frostbite only because of a house fire, a nursing-home resident who refused cataract surgery with clear capacity, and an emergency amputation avoided until a son’s presence shifted consent. What emerges is a practical, humane framework. Engagement is the pivot: stabilize first, invite voice next, and co-create plans the person can actually carry. History matters—patterns of decompensation, medication responses, and preferred supports should guide decisions, not just a hurried ER snapshot. We talk harm reduction, long-acting medications, creative supports, and exhaustive documentation to help teams align and judges see beyond the moment. And we stay honest about the gray: grave disability is debated, rights can clash with safety, and sometimes the kindest act is a firm no until the person, not the illness, can say yes. If you’ve ever stood at a threshold wondering whether to knock again or walk away, this conversation offers clarity, language, and tools to act with courage and care. Listen, share with someone who needs it, and leave a review to help more families and providers find their footing in the gray. If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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May 14 · 1 hr 3 min
An Off Switch For Neurospicy Brains with Danniel Worthen Cullumber
Send us Fan Mail Trauma doesn’t always arrive like a lightning strike. Sometimes it settles in, becomes routine, and starts shaping the way a whole household breathes, talks, sleeps, and copes. We sit down with Danniel Worthen Cullumber, MSW, LCSW of Willow Medela Wellness, a Utah trauma therapist and licensed clinical social worker, to name what that kind of trauma really is and why “just move on” is often the least helpful advice a family can hear. We get honest about the medical model and the ways it can unintentionally add stress: reactive care, inaccessible systems, endless portals and paperwork, and insurance-driven decisions that can delay support. Danielle shares how stigma around diagnoses, including autism spectrum disorder and broader neurodiversity, can shut doors and push families into workarounds that shouldn’t be necessary. We also dig into generational trauma, how stories and biology can carry fear forward, and why caregiver burnout is a predictable outcome when support is treated like a luxury. From there, we focus on what helps: trauma-informed care as a client-centered approach built on compassion, listening, and autonomy of choice. Danielle explains nervous system regulation and why people can “switch on” fast but struggle to switch off, especially after prolonged stress. She also breaks down Accelerated Resolution Therapy (ART), a bilateral eye-movement method related to EMDR that aims to change how the body responds to distressing memories and triggers. We close with a teaser on holistic work and paranormal experiences, and how to handle those conversations ethically without dismissing people or making it about the provider. If you’re a caregiver, clinician, or family member trying to keep it together, hit play, then subscribe, share this with someone who needs it, and leave a review so more people can find trauma-informed support. Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2? If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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May 7 · 48 min
The Kidz Are Alright (Kinda) with My Kids
Send us Fan Mail The kids are not confused about what they need. They’re tired of performing, tired of being reduced to a checklist, and tired of pretending the pressure isn’t real when the “social mirror” lives in their pockets 24/7. We sit down with five young people spanning ages 13 to 23 and ask the questions adults usually dodge: Do you feel watched at school? What kind of support actually helps? Is a mental health app enough when your chest is tight and your brain won’t shut off? You’ll hear how real friendship creates safety, why asking for help can feel harder than finding help, and how embarrassment, perfectionism, and fear of judgment show up in everyday moments. We also talk about teen mental health, youth mental health awareness, and the double-edged reality of social media and mental health, including how it can reduce stigma while fueling comparison. We go deeper into what schools and systems get wrong, from separating kids with specialized needs to skipping life skills that many students never learn at home. Faith shares what it’s like when professionals see a diagnosis on a screen instead of the whole person, and Jake reflects on the challenge of naming feelings as a young adult leader in the military. We end with a reminder that positive mental health is a daily practice, and that presence beats perfection every time. If this conversation hits home, subscribe, share it with a parent or educator, and leave a review so more families can find it. What’s one piece of “head trash” you want to clear out this week? Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Join Our Group: Mental Health Resource Network: Mental Health Resource Network | CARE Coalition | Facebook And become part of the Care Coalition: Serious Mental Illness Support | Care Coalition Homepage On lIne Course https://guardian-academy.thinkific.com/ Featured Books by Michael Saving Melissa: 7Cs to Cure the Mental Health System https://www.amazon.com/Saving-Melissa-Mental-Health-System/dp/0997421401/ref=sr_1_4?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383637&sprefix=mackniak%2Caps%2C305&sr=8-4 Character: Become the Person Your Social Media “Friends” Already Think You Are https://www.amazon.com/Character-Become-Person-Friends-Already/dp/1790810612/ref=sr_1_2?crid=2M5UMT3SGX4F2&dib=eyJ2IjoiMSJ9.qTdx0uEZUvp8BB4cVx5nFF3asxtsbS9tk4J8iW1JOBTWeuKmhJNwn1ScqH9mM_KM3GhLBDHRQXsx5jLZVo9mUg.HidshKcNsUtePdlJzX2rEGe_jlxKyVCQiPmtAcygZh0&dib_tag=se&keywords=michael+mackniak&qid=1777383719&sprefix=mackniak%2Caps%2C305&sr=8-2 If Holding It Together has encouraged or helped you, consider supporting the mission. Every coffee helps us continue providing peer support and resources. ❤️ https://buymeacoffee.com/carecoalition Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/ Download this episode companion worksheet here: https://michaelmackniak.org/free-listener-action-guides Get the Journal https://guardian-academy.thinkific.com/courses/CareKeeperJournal Become part of the Care Coalition: https://carecoalition.org/
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