Bemidji ARMHS Team Welcomes Ashley Rohr

LCA News and Information

Lake Country Associates welcomes Ashley Rohr to our Bemidji Adult Rehabilitative Mental Health Services (ARMHS) team.  Ashley recently moved to the area with her husband and two kids.  She has over ten years of experience supporting adults with a variety of disabilities and mental health conditions.  Having worked in residential and community settings, she has a passion for finding creative and constructive ways to help people manage their symptoms and focus on living their best lives. 

One of Ashley’s passions is helping people get past the fear of stigma and judgement related to mental illness and helping people communicate their needs.  She has experience working with people with physical disabilities,  PTSD, chemical use and family trauma.  In her free time, she enjoys reading, crocheting and spending time outdoors with her family.  To make a referral to Ashley or for more information about our ARMHS program, call Lake Country Associates at 218-444-2233 or go to our ARMHS page. To make a referral to ARMHS, complete an ARMHS referral form and fax it to us at 218-237-2520.

Chris Ross Provides Mental Health Rehabilitation in Bemidji Area

LCA News and Information

Chris Ross recently joined the Adult Rehabilitative Mental Health Services (ARMHS) team in Bemidji.  He has spent the last 25 years supporting people in the Bemidji area.  Chris received a Bachelor of Arts degree from St. Cloud State University in Psychology. He has spent most of his career working with children, teens and families in a wide variety of multi-cultural settings, on mental health and behavioral issues.

Chris Ross believes in building strong relationships with his clients and community organizations to provide the best possible outcomes for success with the people he supports. He looks forward to having an opportunity to work with you or your loved ones.

ARMHS is a program that provides mental health rehabilitation to people with mental health diagnoses including anxiety disorders, bipolar disorder, depression, major depression, schizophrenia, borderline personality disorder, and other serious mental illnesses.  ARMHS Practitioners meet with people in their homes and communities and teach skills for managing the symptoms and challenges of mental illness.  ARMHS services through Lake Country Associates do not require a diagnosis of Serious and Persistent Mental Illness (SPMI), but functional impairments the person is experiencing must be directly related to their mental health.

LCA Welcomes Drew Jaeger, MSW, LGSW

LCA News and Information
Drew Jaeger

LCA’s Bemidji office welcomes Drew Jaeger, MSW, LGSW to their team of professionals. Drew Jaeger provides counseling services for adult individuals, adolescents (ages 14+), and couples. Drew believes in person-centered therapy that considers the whole person (mind, body, spirit) and uses strength-based, evidenced-informed strategies to partner with those whom he meets. Each person is considered an expert of their own experiences as client goals are pursued, together. Drew has experience working as a mental health professional since 2015 and in that time has enjoyed engaging clients through psychotherapy, adult rehabilitative mental health services, case management, and psychometric testing. Today, he commonly assists clients by helping to build coping skills, regulate emotions, overcome communication difficulties, and aid in relational dissatisfaction.

Drew is a Licensed Master Social Worker and holds a Master’s Degree in Social Work from the University of North Dakota. Drew has additionally earned two undergraduate degrees (Bachelor’s of Science in Psychology; Bachelor’s of Science in Social Work), along with a Minor in Religious Studies from the University of North Dakota. He serves client populations with a wide range of diagnoses and symptoms through evidence-based practices such as Cognitive Behavioral Therapy (including Dialectical Behavioral Therapy), Motivational Interviewing, Solution Focused Therapy, Narrative Therapy, and Enhanced Illness Management and Recovery.

He and his wife presently reside in Bemidji, MN. In his recreation time Drew enjoys exploring the outdoors (camping, hiking, biking, canoeing, skiing…you name it!) as well as engaging hobbies like leatherwork and knifemaking.

To make an appointment with Drew Jaeger call 218-444-2233 or visit our appointments page.

Isaiah Chalmers, Mental Health Practitioner

Isaiah Chalmers Joins Bemidji ARMHS Team

LCA News and Information

Lake Country Associates welcomesIsaiah Chalmers, Mental Health Practitioner Isaiah Chalmers to the Bemidji team of professionals!  Isaiah works as a Practitioner in the Adult Rehabilitative Mental Health Services (ARMHS) program.  ARMHS is a community-based program that teaches people skills to manage their mental health symptoms while living in their homes and helps them avoid hospitalization.

Isaiah is from Bemidji and is ecstatic to be back in the place that he calls home.  He received Bachelor’s of Arts degrees at the University of Minnesota, Morris, where he studied to become culturally competent in helping relationships.  Isaiah has background in working in adult foster care and assisted living, helping them foster independent lifestyles and make steps towards living on their own.  He thoroughly believes and will strive to make mental health services available to all demographics and populations throughout his career.  Isaiah is excited to work in the Bemidji ARMHS program and support the community he grew up in.

There is currently no waiting list for ARMHS services in our Bemidji program.  To serve our community during the pandemic, services are currently offered either in-person or via telehealth, depending on the needs of the recipient.  For more information or to make a referral, call us at 218-444-2233 or download a referral form, brochures and other information on our forms page.

Welcome to LCA Isaiah!

Worrying about the Future with Covid-19

LCA News and Information

By Diane Cerven, LPCC

I’ve heard many worries that the virus will be around for the next 1-2 years. We don’t know what the future holds and, because of that, we need to modify our thinking and not worry about tomorrow. I know this can be hard, especially for those that try to keep control in their lives but if you focus on the things that you have control over your worries will decrease and that will lead to a decrease in stress.

Create Your New Normal

Things could change again shortly, in which case you will adapt again, but with the information that you have today create your new normal. Organize, schedule, and plan for today with today’s information. Remember that we can take care of our needs, those around us, and still be ok.

post it note picture

Get the Help You Need as You Need it

There are many who have been able to get government help for their businesses/employees, unemployment, and from friends and neighbors. Keep looking for the help and asking for help. This is an unprecedented situation that we are all doing the best in. Do what you need to do for today.

Keep Yourself, Your Family and Others Safe

Some are wearing thin of the precautions and the shut downs. Do what you know to stay safe and keep other’s safe. Don’t worry about what other people are doing, take care of you and yours. It only adds unnecessary stress to get anxious, angry, or depressed about other people’s actions. Focus on you and do what you know is needed, that’s all that you’re in charge of.

Take One Day at a Time

You can manage today, just as you’ve managed in the past. Keep it simple, keep in your control what is in your control, and then let the rest go. When your mind tries to take off with the future or with other people, stop it, remind yourself of what you can take care of (ps that’s yourself and your immediate family like your children), and what you are doing. Everything else let it go.

There are many things that we don’t know. Worrying about what could happen will only strain us. It won’t stop the future or change it in anyway, other than the effects stress has on our own bodies. Go back to today, organize, plan, and take today’s worries only. In reality, you only have this moment, and you can handle this moment.

Do you need extra help?

If you feel that you need extra help because your anxiety feels too big, we’re here for you. Give us a call. We’re offering mostly online counseling at this time, with a few clinicians offering face to face. Call us at 218-366-9229, Park Rapids, or 218-444-2233, Bemidji.


Diane Cerven, LPCC

A Guide to LCA Virtual Groups and Drop-in Hours

LCA News and Information
Lake Country Associates Virtual Group Meetings Phone

by RJ Wattenhofer

Whether you are a person who has attended LCA Cottage groups and drop-in hours in the past or are a first-timer, this guide will show you how to connect virtually through computer or phone so you can begin participating and expand your social support network.

Trying something new can be intimidating and so if you do not feel comfortable “jumping right in” you have the option of turning off your video and entering the Zoom room with a black screen (see picture) which will give you the opportunity to simply look around until you feel ready to participate.

The first step is to download and install the “Zoom Cloud Meetings” app. You can find this in your phone’s app store.

The second and final step is to find available days and times of groups and drop-in hours.

Click this link to view the LCA Calendar of Events: CALENDAR

Ready to get started? Click this link to join:

If you wish to attend with audio only (no option to turn on video) you can click this number to join via phone call: +13017158592 ,,4239727228# – listen for the code to auto-dial and the woman to finish speaking and then push # to join. If you do not own a smartphone then you will want to use the audio only feature. You will need to hand dial in both the phone number and access code.

NOTICE: All events are screened and carefully monitored to ensure confidentiality of participants and to eliminate potential external disruptions of services.

Dealing with Depression During COVID-19

LCA News and Information

By Diane Cerven, LPCC

Our entire world has changed as we hunker down during this pandemic in order to keep ourselves, our loved ones, and others safe. This change was unexpected and far-reaching. What we were doing a couple months ago and even last year at this time has been altered for safety. Changes in our environment affect our mental health.

picture of a question mark

What are some of the things that you can do to better your mental health? Here’s a list of important things to help alleviate depression symptoms.

  • Talk with someone – During this crisis our normal routines have been completely disrupted. For some they are doing at home schooling, not going to work or social activities. Isolation is a symptom of depression that we need to combat. Are you taking the time to connect with important people in your life including family and friends? Zoom, messenger, facetime, and phone calls are all important for connection. Perhaps join online chat groups or communities to connect with others. There are many ways to connect, find them and make it a priority.
  • Move – gyms and community centers are closed at this time but we can go outside. Find the time of day that works best for you and make it a priority. Getting into nature is another benefit that will help your depression. We all have been told how doing exercise alleviates depression symptoms this is still true during our quarantine. Find things that you like to do that will get you moving. You can also move in the house, YouTube has so many in home exercise videos you can choose from. (for other ideas or more information go to: )
  • Make a Plan for the Day – Lack of motivation to do things is another symptom of depression. To combat this schedule activities to get done. Get out of bed at a regular time and plan to accomplish even just one thing during the day. There are many things that need to be done in our homes, yards (maybe even do some planting), and sheds/garages. Tackle a project even if you don’t feel like it.
  • Eat healthy – Many of us have chosen to eat more convenience food during this time. Make a change to healthy options. Our food choices affect how we feel because it’s the food that our body is running off of. At this time make small and healthy changes to your diet, or change back to your healthier options if you moved to unhealthy choices. This is an important point in our overall well being. (more information can be found here: )

There are many things that we can focus on to help us decrease our depression symptoms during this time. Of course you may need a professional counselor to help you even more. You are not alone as many have chosen to get extra help. Call our office if you would like to make an appointment at 218-366-9229 for Park Rapids or 218-444-2233 for Bemidji. We are doing telehealth counseling appointments at least through June 2020 or longer as is safest for our staff and clients. For more information on telehealth go here:

Let’s take care of ourselves and by taking care of ourselves we can take care of others. No matter what is going on around us, you are always a priority.

Many blessings,

Diane Cerven, LPCC

LCA Welcomes Paula Ocampo, ARMHS Practitioner

LCA News and Information

Paula OcampoLake Country Associates is happy to announce the newest member of our team in Park Rapids.  Paula Ocampo has been working as a Mental Health Practitioner, providing Adult Rehabilitative Mental Health Services (ARMHS) services to people in the Park Rapids community.  Paula’s is a Registered Behavior Therapist with over 3 years of experience providing behavior therapy to children, adolescents, and adults with various mental health diagnoses and various levels of independence.  Paula is a Park Rapids High School graduate and obtained her Bachelor of Psychology at Concordia College in Moorhead, MN.

For the last 2 years, Paula has been working with children ages 2-6 years old diagnosed with Autism in Austin, Texas. She is now back in her home town working as an ARMHS Practitioner and is eager to be providing quality care to adults in her community.  She is currently in graduate school studying Clinical Counseling and is looking forward to continuing to provide therapy to people in need in the Park Rapids area.

Welcome to LCA Paula!

Telehealth; An Important New Tool in our Mental and Physical Self Care Toolbox

LCA News and Information

By Kari Tomperi

Old Telephone

History tells how critical the invention of the “tele” graph was in keeping families, businesses, and governments informed and in communication with each other. Then the invention of the “tele” phone gave even more people access to communication with their neighbors and their doctors and business associates. Don’t forget the “tele” vision that allowed people to actually see other people while they were informed through the news or entertained through movies and weekly series. As computers and cell phones add a new “tele” to everything from “tele” medicine to “tele” education we need to remember it is just a tool that helps us communicate better.

Telehealth is different from telemedicine in that it refers to a broader scope of remote health care services than telemedicine. Telemedicine refers specifically to remote clinical services, while telehealth can refer to remote non-clinical services. Telehealth can focus on either our mental or physical health or both.

Wikipedia tells us “telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap.”

With the current restrictions due to the CoVid-19 virus where we are asked to physical distance a minimum of 6 feet and to protect ourselves and others by wearing masks, our ability to talk to someone over a computer or phone screen is a chance to connect or communicate freely. We are lucky we are far enough into the virtual meeting space technology that this is a doable option. Businesses that provide these services are ever mindful of the need for privacy and carefully scrutinize how and when and who is a safe provider of telehealth services. Until we can meet face to face comfortably, it is a good second option or tool in our toolbox to access those services that make our lives better and more informed.

It is a personal choice how you can accesstelehelath services but in this “New Normal” we all need to be thinking and working together to find the best approaches for everyone. Just as you need to think of new ways to take care of you, your home and family in these trying times isn’t it nice to know there is an option that can protect them yet take care of everyone’s physical and mental health needs.

Kari Tomperi is a mental health advocate and staff member of the Lake Country Cottage drop-in center in Park Rapids.

LCA Welcomes Melissa Saunders, Certified Peer Recovery Specialist

LCA News and Information
Melissa Saunders, Certified Peer Recovery Specialist at Lake Country Associates.
Melissa Saunders, CPRS

Lake Country Associates welcomes Melissa Saunders to the Substance Use Disorder (SUD) team in Park Rapids and Menahga. After graduating from an intense training program at the Minnesota Adult and Teen Challenge Program in Minneapolis and passing her exams at the Minnesota Certification Board, Melissa joins Lake Country Associates as our first ever Board Certified Peer Recovery Specialist (CPRS).

A CPRS is someone with lived experience in recovery who partners with people in need of additional support in their own recovery. The role of a CPRS is not the same as a sponsor. A CPRS focuses on being an advocate, a role model and a mentor. They work in partnership with mental health and substance abuse counselors and help people overcome barriers to recovery.

Melissa grew up in Hubbard County. She has one adult son and is an animal lover. She has been in recovery for over five years and is very passionate about the recovery journey. Melissa believes that with the proper tools, help with utilizing resources, and a healthy support system, recovery is possible. She believes in compassionate support, helping people break their goals down, and taking them on step by step.

More About Peer Recovery Services

For more information about CPRS services or any of LCA’s services for people with chemical dependency, call Lake Country Associates at 218-366-9229. You can also follow this link to LCA’s Substance Use Disorder program page.

Reducing Physical and Emotional Clutter

LCA News and Information

By Kelly Brevig

Cluttered desk drawer.
People with cleaner homes experience better physical health than their less organized friends.

“Where does this go?” my husband asks as he stands in the doorway of our massive, catch-all closet. From the other room, I replied, “The second shelf down, right-hand side, just lower than my line of sight, in a pink basket.” I’m hoping he finds the right spot, or the storage space might avalanche. This closet is an epicenter of stress. One false move and we will be buried in half-done projects, seldom-used kitchen items, pictures, board games and every item that doesn’t yet have a home. Clutter, while supposedly the sign of a genius, can negatively impact our mental health by causing stress. Albert Einstein was known to have a messy desk. He was also intuitive, creative and a visionary. I am no “Einstein” by any means, yet I have often felt comfort in knowing that creative minds tend to have messy environments. Validated by this thought, our closet has now taken on a life of its own. This barely-contained chaos has got to go.

Dorothy Day once said, “Life itself is a haphazard, untidy, messy affair.” Life is messy; my house doesn’t have to be. In doing a bit of research, I’ve found that women disproportionately encounter higher levels of cortisol (the stress hormone) when their environment is disorderly. In contrast, people with cleaner homes experience greater physical health than their less organized friends. Clutter can interfere with pleasure and lead to procrastination. It can negatively impact our working memory and cause sleep deprivation. Fear of being discovered and judged a hoarder can cause embarrassment and even isolation. Hoarding itself is linked to obesity and binge eating. Mind-wandering, pleasure-killing clutter can stop us in our tracks and hijack our self-control. How do we get it back?

Letting Go of Clutter

Taking control of one’s life can be easier said than done, especially if depression and anxiety are involved. Often times we may have good intentions, but not sure exactly where to begin. I’ve recently been inspired by a series on Netflix titled, “Tidying Up” with Marie Kondo. Seeing other people learn how to organize and eliminate unused items has been inspiring. There are many resources on the Internet and within our community which can assist us in helping simplify and organize our lives. One of the things in common with the methods I’ve researched is to let go of items that are no longer used. It doesn’t matter if you donate, sell, or bring your items to a consignment shop, letting go of things can be validating and increase our generosity. Being generous creates feelings of self-satisfaction and bring happiness. Also, actually starting a project is necessary if it is going to ever get done. The mountain might be big, but it won’t move by itself. Don’t be afraid to start small and ask for help. Slow and steady wins the race.

Organized office space free of clutter.
“Home is not a place, it’s a feeling.”

Rome wasn’t built in a day, and neither was my closet collection. In fact, I’m sure there are items in the far corners that were placed there when we moved in 14 ½ years ago. I’m guessing that this “little” project of mine will take longer than a few days to complete. The transparency of that sentence is a bit embarrassing, but I’m betting I’m not the only one with out-of-reach places that are crammed full of things we didn’t quite know where to put. Everyone has “stuff”, both physical and emotional. The goal here is to take control of what we can, let go of things that are no longer needed, and prioritize our life in a way that makes sense and is manageable. It has been said that “home is not a place, it’s a feeling” and that “home is where our story begins.” Here’s to starting the year with less clutter and stress, and increasing our overall health and happiness. This is where our story begins, where we tell it to.

Kelly Brevig is the Suicide Services Coordinator for Evergreen Youth and Family Services in Bemidji, MN.

Depression and the Holidays – A Survival Guide

LCA News and Information
By Diane Cerven, LPCC
Winter Depression

In the last post, we talked about anxiety and the holidays. This time, I want to really focus in on depression. During this time of year, we have the change of seasons, cloudy days and less daylight. We may find ourselves huddled inside with the things of summer long past.  Many people have seasonal affective disorder (SAD) depression during winter, or even SAD compounding depression symptoms that are felt year around.  This is a hard time of year.  Then we add the holidays and their obligations.

Depression affects people in different ways, symptoms can include: loss of energy, loss of desire to do things that had been fun or interesting in the past, feeling sad and hopeless, feeling worthless, concentration and decisions making problems and more.  It can be a lot to handle during this time of year with added things to do, people to care for, and responsibilities to take care of.  How do you take care of yourself, not let depression ruin the holidays, and come through it all with some mental health?

For those with severe depression, counseling can be helpful.  With your counselor, you can work on negative self talk, motivation, and working through situations that have compounded or even caused your depressive episode.  What to do outside the counseling session is what I’m going to try and help you with in this article.  

Set Realistic Expectations

We can’t expect ourselves to do everything that is presented at this time of year.  There is just too much. Make a list or put on the calendar the expectations, then go through them.  What is it you want to do, you really should do, and then cross out the ones that are just added stress.  Go back through the list and really look at the “shoulds”.  The activities that you know you need to do, keep those.  Cross off the “shoulds” that are just expectations and may disappoint others if you don’t do, but are too much or something you don’t want to do.  It’s ok to do that.

If you’re getting a little too “cross off happy” (i.e. depression tells you to do little to nothing this year), stop and think it through.  Don’t just follow depression symptoms like they’re the boss; kick that cognitive brain into gear.

  • If you’re feeling lonely, spend time with others (put that on the list). Choose those who are healthy in your life.
  • If you’re grieving, do something that will honor the person you lost, especially with loved ones (put that on the list).
  • If your just not interested in anything, push yourself to do something you’ve done in the past that has felt good (like lighting of the community Christmas tree and caroling).
Guys throwing snowballs

Self-Care for Depression

Take care of yourself during the holiday season.  Self-care is vitally important when the season gets more stressful.

  • Rest when you need it –  Make sure to get your regular amount of sleep, preferably going to bed at the same time as the rest of the year.
  • Eat healthy foods – Yes, there are a lot of sweets and high fat foods. You can have some, but limit the amount and eat normal healthy meals and snacks.  The change in diet to a high fat and high sugar foods can affects our physical and mental health.
  • Be moderate or sparing with alcohol.  If you’re on mental health medications, most indicate not to drink with them.  Alcohol changes our brain functioning.  Be aware and if you choose to have some, only a little bit.  A healthy liver can process about one drink an hour (a beer, a shot of hard liquor, about 5 oz of wine).  Alcohol can still be detected in your system though; don’t forget to have a designated driver to stay safe. That’s important self-care.
  • Relaxation is important every day, but especially in stressful times.
    • Do passive relaxation daily, like reading a book, taking a bath, playing with your dog or cat, playing games, listening to music, playing music, watching the fire (online if you don’t have one) or limit screen time because what we watch is stimulating.  This is choosing something you find peaceful.
    • Do active relaxation as well.  There are many relaxation apps, YouTube has so many relaxation videos you could do a new one every day.  I recommend keeping a link to the ones you find you like.  There are several different kinds: progressive muscle relaxation, deep breathing, breathing meditation, guided imagery, stretching, meditation, etc. Anything that causes your muscles and mind to relax, letting the tension go.

Good self-care this time of year will go a long way toward helping your depression and anxiety symptoms.

Other Self-Care Ideas

Here are some other options to help your mental health:

  • Set Boundaries – I talked about this in the last article with anxiety and the holidays and specifically about boundaries here.
  • Get a SAD lamp. These emit light that wakes up our brains and deter the effects of the shortened and gloomy days.
  • Ask your doctor about your vitamin D levels. These can lower with less sunlight as vitamin D is converted from sunlight in our skin.
  • While at the doctors also have them check your thyroid levels as low thyroid causes depression symptoms.
  • Set aside differences with family and friends. Enjoy the day(s) without getting depressed about the past.
  • Make a tradition of relaxation and fun with the family.  You don’t have to have a large celebration with all the glitz and glam, you only need to be together and doing things together.  That’s what people remember, the love and care you show each other.

The most important thing is to know and set your limits.  Push yourself to do the activities you know you’ll be disappointed if you miss.  Skip the ones that are just stressful.  You can make it through and manage depression over the holidays.

What’s the Next Step?

Follow us on Facebook to see when the next blog is posted, or check back here.

You are important and so is your mental health.  If you need more help, we’re here for you. To schedule a counseling appointment, call us at 218-366-9229 (Park Rapids) or 218-444-2233 (Bemidji).  For those interested, I offer Christian counseling out of the Park Rapids office or Thursday in Bemidji.  Please let our office support staff (and me) know that you are interested in Christian counseling.  Please check out our staff bios.


Diane Cerven, LPCC

Open House set for LCA Substance Use Disorder Program

LCA News and Information
Lake Country Associates Logo

LCA welcomes community members to stop in for an open house in our new Menahga office! The Menahga site offers Substance Use Disorder (SUD) treatment in various levels of care, individually or in a group. Our Menahga site also offers mental health services, such as diagnostic assessments, individual therapy, and ARMHS services.

At Lake Country Associates we offer chemical use assessments including Rule 25 Assessments, Comprehensive Assessments and non-residential treatment.   Individuals can receive a chemical use assessment at our Park Rapids and Menahga locations.  Non-residential treatment is offered at our Menahga location. 

Our non-residential program offers three levels of care including high intensity, medium intensity and low intensity: 

  • High intensity program allows individuals meeting this level of care to attend group sessions three times a week and participate in individual sessions as needed. 
  • Medium intensity program offers people two group sessions weekly and individual sessions as needed.
  • Low intensity program includes one group session weekly and individual sessions as needed.

Our program allows clients an ability to step down from high intensity, medium intensity and then to low intensity at their own pace, based on their progress and ongoing needs.  People are also able to increase levels of care while in our program if their needs warrant an increase in non-residential programing.  Lake Country also has the ability to make referrals to programs that offer higher levels of care including referrals to residential programs.

LCA would like to extend this invitation to our community partners, county agencies and to the public to visit our new office.  This open house will provide an opportunity to hear more about the levels of care offered, meet with our staff and learn about other services we provide.


11 NW Main Street in Menahga (on the corner of Highway 87 and Hwy 71)

White Pine Center building In Menahga MN


2PM – 4PM on January 15th


All community members, providers, and other interested parties are welcome to attend. We will be providing refreshments and a chance to meet our providers. 

Lake Country Associates serves individuals in central Minnesota including individuals in Wadena County, Becker County, Hubbard County, Ottertail County, Beltrami County, Todd County, Cass County and beyond. For more information or to schedule an appointment, call 218-564-9229 (Menahga) or 218-366-9229 (Park Rapids). 

Take Control of Your Reaction to Stress

LCA News and Information

By Kelly Brevig

“We cannot control what happens to us, but we can control our response.”  The internet is full of quotes like this by various authors. We might be used to reacting to things out of our control, like other drivers, political posts from the opposition, and even the weather. Some things we experience can truly grind our gears. We might find ourselves in a state of agitation because some cars don’t believe in blinkers, or some drive 8 miles an hour under the limit in great road conditions, or when your cashier flips their trouble light. It can be a challenge when things don’t seem to go our way. Here lies the rub; our response to everyday irritations may be making us sick.

Stressful driving
Mounting anxiety or anger can release adrenaline and increase blood pressure.

Mounting anxiety or anger can release adrenaline and increase blood pressure. The fight-or-flight response can prompt the nervous system to cut off blood flow to the digestive tract and increase stomach aches. Over time, anger can encourage fatty deposits to pile up in the heart and carotid arteries. Serotonin, a chemical in the brain associated with happy feelings, is diminished and increases the likelihood of depression. This seems like an awful lot of control to give to someone who we allow to push our buttons, or at the very least, “don’t even know how to drive.” How do we learn to change our responses from a state of anxious agony to an attitude of optimism?

We need to act not react. An initial healthy step is to stop and breathe. When blood pressure is rising and the heart rate is accelerating, taking a few deep, long breaths can slow things down. It tricks the body into thinking, “There’s no panic here. Everything is chill, calm, and manageable.” We give space for our brains’ frontal lobe to take control. The “4-7-8” method of breathing is one technique that can help accomplish this task. Breath in for four counts through the nose, hold the breath for seven seconds and gently blow the breath out of the mouth for eight seconds. For the best results, repeat this pattern at least 4 times. Too complicated? Try a slow five count inhale followed by a slow five count exhale. Repeat. Repeat. Repeat.

Breathing to Relax
When blood pressure is rising and the heart rate is accelerating, taking a few deep, long breaths can slow things down.

As we gradually take control of our physical reactions to stress, we can begin to do a little cognitive restructuring. Consider the reasoning behind other people’s bad or irritating behavior. Perhaps there is a logical reason that things are not lining up the way we would like and it has nothing to do with us, thus taking away the sting of being personally slighted. Circumstances out of our control can be frustrating, to say the least, but we do have the ability to “talk ourselves down” and go with the flow.

If we find ourselves in a constant place of anger and irritation, we might need to step up our response game. Life’s pressures could be overwhelming at the moment.  We could benefit from a healthy outlet for mounting tension. Exercise, (while easier said than done when feeling unmotivated) can be a great safety valve and natural antidepressant. The trick is in getting the shoes laced up and out the door. If you show up at the gym, you’ll probably do some exercise. If you can cross the threshold of your front door, you’ll likely take that walk. Explore talk therapy. Venting about our issues is a great way to blow off steam and get some of the toxins out of our system. It can feel good to be validated and affirmed. Medication can also be a helpful tool in self-regulation. Talking to a doctor is always an excellent idea anyway in preventative care.

While it may be true that we “can’t control what happens to us,” we can learn to control the way we respond to stress. We might even learn to find the humor in situations, like when the car in front of us runs out of blinker fluid. Remember that we are all human and no one is perfect. In the event you may see me blowing a gasket sometime in the future, please remind me to breathe.          

Kelly Brevig is the Suicide Services Coordinator for Evergreen Youth and Family Services in Bemidji, MN.

Anxiety and the Holidays – A Survival Guide.

LCA News and Information

“The most wonderful time of the year,” we hear sung to us over the air. For many, this is the most stressful time of the year. Even for those without mental health issues we can find the holidays packing on the extra stress with all the things we have to do. With a mental health diagnosis or symptoms it can compound symptoms that already feel debilitating and limiting.

Christmas Anxiety
For many, this is the most stressful time of the year.

For anxiety, whether general, social, phobias, or even PTSD, the holidays can be a hot bed of cortisol and adrenaline (two of our stress hormones). We have so many obligations: family gatherings, work parties, friends who want to celebrate with us, presents to buy, cards to write, food to make, and don’t forget shopping for all of the above. The list can seem endless and the weekends are packed with getting ready for and going to different obligations.

What can a stressed out person with anxiety do?

  • First, simplify by making things easier.
    • Buy pre-made food or contribute one item to a gathering and have others contribute as well
    • Write a short holiday greeting in your card instead of an entire letter
    • Give gift cards or shop online
    • Write out your to-list and find those things that you don’t need to do or can make simpler.
    • PS, your house doesn’t have to look perfect. No really, it doesn’t.
  • Only do the things that you can do.
    • Just because you’re invited doesn’t mean you have to go. Say No to over obligation. Don’t know how to say no, follow this link to my article on boundaries.
    • If family gatherings are extra stressful because of the drama, there are a few options you have:
      • Shorten the time you stay.
      • Talk to your family about having one gathering.
      • Choose a gathering to go to and tell the other parties you can’t make it.
      • You are allowed to not go! Especially in toxic relationships, sometimes the best thing to do is skip it all together. You can go and visit your loved ones at other times, including into January and February when we have nothing else to do anyway.

Sometimes it’s the feelings that stop us from doing what we know we should or what we know would be best for us and our immediate family (take your kids into consideration). That guilt can be added stress on us. Ask yourself is the guilt appropriate or is it pressure from someone else. There are times when we know that a loved one isn’t feeling or doing well and we want to be there for them despite the stress. We feel guilty about thinking about not going. Weigh this out and do what is best for both parties. What will you feel like later if you don’t go? If you do go, can you go at another time? All of our feelings are just trying to tell us something (sometimes very loudly), what is the message and what can you do about it.

Guilt placed on us from someone else can be one of the worst, we know they will say something mean, or allude to a negative quality they think we have. Here is where boundaries and self talk can help. Set your boundaries with the person, “I’m not going to make it to the party.” Let them keep their own thoughts and feelings, no matter what they say or think that is their thoughts and feelings. You may be saying that it’s easier said than done but remind yourself why you’re not going (that’s self talk) and remind yourself of your good qualities (positive self talk). Taking care of your needs is a good quality, by the way. Then let it go. Don’t continue to ruminate on what they said, or how we feel about it, move on to something else, perhaps a distraction skill.

You get to choose your holiday celebration. You can morph them into something you like and can live with. Don’t let this holiday season be stressful and overwhelming. Take control over the things you have control of, instead of letting other people have power over you. You can do this!

Need Support?

For serious mental health concerns we’re here to help.   To schedule a counseling appointment, call us at 218-366-9229 (Park Rapids), 218-444-2233 (Bemidji) or 218-564-9229 (Menahga).  For those interested, I offer Christian counseling out of the Park Rapids office.  Please let our office support staff (and me) know that you are interested in Christian counseling.  Please check out our staff bios here.


Diane Cerven, LPCC

Gun lock

Reducing Access to Lethal Means

LCA News and Information

By Kelly Brevig

When a child first learns to walk, their whole world becomes dangerous. Unsteady legs develop as babies pull themselves up and grasp furniture for support. As a child gains a new visual perspective, shiny and breakable objects are tucked away safely, hidden from sticky little fingers that are wanting to explore. It doesn’t take long for a first-time parent to “childproof” their home by locking cabinets, putting up harmful chemicals and plugging electrical outlets with safety devices. The goal is to keep the child as safe as possible. While little brains develop, the whole world is opened up to them and parents quickly learn how to protect them the best they can. Bath time becomes a ritual that is closely monitored, tiny objects that can fit into tiny mouths are picked up, and seat belts are used to keep babes tethered securely in swings and highchairs. We do everything in our power to keep them safe.

child with bike helmet
As children grow, dangers morph from choking hazards to external injuries and accidents.

          Babies are not able to rationalize and understand the danger. As they develop, the meaning of “no”, “hot”, “icky”, is gained through experiences. The human brain develops at a heightened pace and much is absorbed through play, safety, and storytime. As children grow, dangers morph from choking hazards to external injuries and accidents. The world around us evolves to present a new set of risks. Bike helmets, rules, expectations, and curfews are enforced to guide us and help us further develop our frontal lobe- the part of the brain that makes decisions, solves problems, provides flexibility, and sustains memory.

          After successfully navigating childhood into adulthood, it can be incomprehensible to believe that one of the biggest dangers a person can face, is themselves. When a person is experiencing depression, however, the pre-frontal cortex that so readily helped us solve problems, make decisions, and rationalize the world, can go dormant, while other brain systems like our amygdala, (the emotion sensor of the brain) take over. Our amygdala is important to us, as it senses danger, heightens our awareness, releases adrenaline and cortisol and helps us to fight, flee or freeze. It can also be hijacked by depression and provide emotional responses that are overwhelming and override brain function.

What can we do?

          Depression and anxiety are chemical changes in the brain. Someone who is experiencing depression loses the ability to rationalize the world around them and can have daily battles with their amygdala to just get out of bed. Because these chemical changes do not present themselves as clearly as a broken leg, they are often misunderstood and not talked about. It is in this state that suicidal thoughts enter and a person becomes a danger to themselves. Just as an infant learning to walk needs someone to navigate the world around them to keep them safe, so does a person experiencing depression. One of the best ways to do this is to reduce access to things that could cause irreversible harm. Just as kitchen cleaners are put away for child safety, so are guns and medications locked up and out of reach for someone experiencing depression. When we make it harder for someone to access ways of ending their life, we give them more time for their pre-frontal cortex to fight for control and provide the ability to stop themselves.

Gun lock
Just as kitchen cleaners are put away for child safety, guns and medications should be locked up and out of reach for someone experiencing depression.

          Because it is difficult to imagine a loved one being so distraught that they are filled with thoughts of death, it can be hard to put up a “safety gate” or barrier to what we think is improbable. It is more comfortable for us to believe that suicide strikes “other people” and not our own. What we know about suicide, however, is that it is an impulsive act with little to no reasoning. Simple safety measures like extra gun locks, removal of ammunition, disposing of unused medication and locking up all others can be lifesaving. The goal on this end of the spectrum is to keep people safe from themselves by providing as much time as we can for the brain to jockey for control. Safety in our world is talked about every day. When we begin to marry “safety” with “depression”, we can save lives. Help us make reducing access to lethal means a common practice when dealing with depression.       

Kelly Brevig is the Suicide Services Coordinator for Evergreen Youth and Family Services in Bemidji, MN.

Time to Slow Down

LCA News and Information

By Kelly Brevig

Greek philosopher, Socrates forewarned us when he said, “Beware the barrenness of a busy life.” Yet today, everywhere we go it seems that people are bustling around in a race against time. We live in a society where we glorify business and identify ourselves by our to-do list. “Hi, how have you been?” we ask, and the reply, “Oh, I’ve just been so busy lately.” While self-satisfaction can come with accomplishment, we recognize the need to slow down and take a break, thus inserting vacations and mental health days into our world.  However, the real question is, “how do we create a world from which we don’t need to escape?”

busy female professional

Some people believe the Mandarin character for “busy” is made up of two words, “heart” and “death.” While the translation can be argued, this interpretation could mean that having our time consumed can be physically stressful to our bodies, or separate us from our loved ones, it can also mean that business helps us to shut off our emotions. While being too busy can lead to unnecessary stress, it can also have some positive results. Sometimes, keeping busy can be an escape from intrusive thoughts. Doing mindless tasks or tasks requiring concentration can be a great tool for self-care. What happens though when we create calendars that fill up faster than we plan for and we forget to process the “stuff” inside our heads?

Being “swamped” or “up to our ears in paperwork”, having our “plate full” for long periods of time can lead to high cortisol levels. While there is a tendency to “dig deep and keep going”, doing so can also bring extreme exhaustion when it is repetitive without a break. Too much cortisol in our body leads to anxiety, depression digestive problems, headaches, heart disease, sleep problems, weight gain and memory/concentration issues. Sound familiar?  On the flip side, when people take their “work break” that is required by MN state statute, it helps the pre-frontal cortex (the part of our brain that helps us concentrate and make decisions) recharge so it can carry on and complete a task. We need to take a break. We are designed to work in moderation. We are more productive and effective when we give our bodies a chance to slow down.

Looking at the Finnish culture for a different perspective, we can find that coffee breaks are part of the natural order of things and the law. Breaks are not spent on smartphones, running errands, or conversing about work, they are mostly spent in silence drinking coffee. Finns appreciate a true body and mind break that allows for thinking and processing. Chatter during this time is considered “noise.” Fins also have more sauna’s (pronounced sow-na) than cars, exemplifying the importance of self-care.  While it is true that people in Finland are said to be better listeners than talkers, it can be argued that silence too, should be taken in moderation. Talking about one’s thoughts and emotions has been proven to be a healthy outlet and a necessary part of dealing with grief and depression.

relaxing in a boat

So the question remains, how do we create a world in which we don’t need to escape? Planning coffee breaks (or just a chance to go outside and breath the fresh October air) is a great way to start. Many people have said to me, “Where did the summer go?” My goal for the fall is to enjoy each moment, being present to enjoy the crunch of leaves, the autumn colors, the laughter of my family and the love from my dog. Taking meaningful time outs in our daily lives bring moments we can look back on and remember. Someday, most of us will have the chance to sit and reflect on the years behind us. Will we say that we were busy, or that we found meaning in every day? It is never too late to slow down. Our families and work both need us. It is when we truly slowdown that our best and most productive selves emerge. Use those built-up vacations days; your future self will thank you.

Kelly Brevig is the Suicide Services Coordinator for Evergreen Youth and Family Services in Bemidji, MN.

Suicide Prevention: Learn When It’s Time to Seek Help

LCA News and Information

by Melissa Howard

picture of depressed person

Suicide is a travesty that affects millions of people all over the world. When a person decides to take his or her own life, they leave behind a slew of impossible questions and difficult emotions for their loved ones: What do we do now? Why did this happen? Is there anything anyone could have done to prevent this from happening?

Warning Signs of Suicide

There is no one reason why a person decides to end their life. People have their own experiences and troubles that influence them along with mental health struggles. Typically, people who engage in suicidal acts don’t necessarily want to die; it’s more like they just want an escape from pain that they see as unmanageable and unbearable.

Substance abuse is another factor that increases the likelihood that a person might wish to die. Mental health issues such as anxiety, trauma and depression often co-occur with drug and alcohol addiction. Even after seeking clinical treatment, addicts often experience residual guilt, financial problems, and damaged self-esteem that can contribute to thoughts of suicide.

Signs someone may be thinking about suicide include:

  • Talking about suicide
  • Mentioning feelings of hopelessness
  • Expressing a sense that they are a burden to others
  • Feeling trapped and like life is meaningless
  • Loss of interest in things previously enjoyed
  • Drug and/or alcohol abuse
  • Online searches for ways to kill themselves
  • Isolation from family and friends
  • Sleep disorder and fatigue
  • Aggression, rage, and irritability
  • Saying goodbyes and giving away items
  • A history of depression, anxiety, and/or PTSD

If you have a senior loved one in your life, you need to pay close attention to them, especially if they live alone. Loneliness, depression, and isolation are prevalent within the senior community, making older adults susceptible to suicidal thoughts. So, check in with your senior loved ones and see if they display any signs of senior isolation. If you suspect a loved one may be suffering from depression, encourage them to seek help. Fortunately, many Medicare Advantage plans, including those offered by private insurers such as UnitedHealthcare, offer a number of important wellness programs that can get them the assistance they require.

Suicide and the Blame Game

When someone takes their own life, the people they leave behind experience the whole gamut of emotions. While not everyone feels this way, some people blame themselves for not doing more to help prevent the tragedy. Others may blame the victim. The truth is that in the event of a suicide, no one is to blame. Life can be cruel and illogical. Sometimes, there are no answers to questions, and bad things happen and there’s nothing anyone could do about it. When recovering from a loved one’s suicide, try to avoid placing blame in any direction. Instead, focus on grieving and healing.

Preventing Suicide with Emotional Wellness

Those who have a history of suicidal thoughts, depression, and addiction can help improve their lives by pursuing a state of emotional wellness. While emotional wellness has a focus on nurturing our instincts and intuition, it’s important to remember that in the end, all aspects of health are connected. To support your emotional wellness and mental health, it’s just as important to take care of your body with proper diet and exercise.

It’s also important to build a supportive team of mental health experts, which may include a psychiatrist, who can prescribe medication as needed; a therapist, who can lead individual or group counseling sessions; and in many cases, a social worker, especially for those who have survived substance abuse or a previous suicide attempt. These specialists help patients of all ages develop emotional wellness tools to help them cope with mental health disorders, including suicidal thoughts. Licensed social workers typically obtain a Master of Social Work program that includes several hours of field work, so they have the hands-on experience needed to help patients struggling with thoughts of suicide through both prevention and intervention.

Other ways to support one’s emotional well-being include:

  • Participating in activities that are meaningful — work, taking care of another, volunteering, etc.
  • Sticking to a routine and maintaining a busy schedule
  • Making crafts
  • Trying new activities and meeting new people
  • Traveling and visiting new places
  • Practicing gratitude throughout the day
  • Taking a day off when needed

Suicide is a serious problem that devastates the people left behind. There is no one reason for a person to take their own life and when they do it. While we can look for signs of a person thinking about suicide, if they end up taking their life, it is important not to blame anyone. We can help prevent suicide by encouraging people to promote their own emotional wellness.

Why Involve Family and Other Important People in Your Recovery?

LCA News and Information
road to recovery

Most people know someone who has struggled with mood-altering substances, alcohol and/or drugs.  Maybe it was a friend, family, neighbor or maybe it was yourself.  If someone’s substance use was causing enough commotion in their life, they may have received an assessment, either a Rule 25 or more recently, a Comprehensive Assessment.  If they were given a diagnosis of a Substance Use Disorder (SUD), they may have been encouraged to attend SUD treatment, in which a treatment plan would have been created.

A treatment plan is a roadmap that lays out the small steps on the road to recovery.  In my ten plus years working as a Licensed Alcohol/Drug Counselor (LADC), I have worked with people on hundreds of treatment plans.  One of the common questions I’m asked during this process is, “Why do we have to involve my family?”. 

Why not Involve others?

There are many reasons people are reluctant to involve others.  One reason is out of fear.  They fear that they will lose relationships and benefits if their secret is exposed: their inability to control their substance use.  They also fear that they will gain something they do not want: judgement or accountability for their actions. 

If they want to continue to abuse substances or do not believe they have a drug/alcohol problem they fear the loss of benefits provided by family or important people who, whether knowingly or unknowingly, may enable their behavior.

Another reason could be that their loved one may also struggle with substance abuse and they want to avoid being embarrassed by them or having others learn of their problems.  Despite the reasons why people may not initially want to involve others in their recovery, their recovery may rely on it.

Why is it important?

Family members and loved ones want to help, though they often don’t know what to do.  By involving them and educating them about the process of recovery, we can increase the chances that they will be helpful and effective in times of need. 

Involving family in treatment planning is encouraged by the designers of treatment programs in our state.  Minnesota Statute says: “The [treatment plan] must provide for the involvement of the client’s family and people selected by the client as important to the success of treatment at the earliest opportunity”.  Not only is involving family and loved ones effective, it’s encouraged by SUD experts across the state. 

Overall, participation in a loved one’s treatment planning process increases the chances of long-term recovery.  It provides an opportunity to address many family concerns, which can include providing resources for family and friends or assisting them in coping in a healthy manner with their loved one’s Substance Use Disorder. 

How does it work?

hands heart

As long as the client signs a Release of Information for the person to participate in their treatment program, family and friends can participate.  Loved one’s participation can occur in a group setting, family session, or even individual sessions with the LADC.  It can also be done through a questionnaire or over the phone.  The important thing to remember is that Substance Use Disorders impact family, friends and other people we care about.  Bringing them into the process allows everyone to heal together.

Need more information?

Lake Country Associates (LCA) is now offering day and evening SUD groups in our Menahga office as well as individual therapy and SUD assessments.  To schedule an appointment, call 218-366-9229 (Park Rapids) or 218-564-9229 (Menahga).  To download brochures and forms, go to our forms page

LCA Welcomes Kris Strate!

LCA News and Information
Kris Strate, Mental Health Practitioner at Lake Country Associates Mental Health in Park Rapids, MN.

Lake Country Associates welcomes Kris Strate to the Adult Rehabilitative Mental Health Services (ARMHS) team. Kris received her Bachelor of Science degree from Mankato State University. For the last 20 years, Kris has been supporting people with a variety of disabilities in the Park Rapids community. She has a passion for helping people improve their quality of life and become their best selves. In her free time, Kris enjoys outdoor activities, spending time with her family and dog, growing orchids and working in her garden.

Kris joined the team in April and is looking forward to helping people better manage the symptoms of their mental illness and work toward recovery. Please join us in welcoming Kris Strate to the Lake Country Associates ARMHS team.

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“My counselor helps me out when I need it most. I can always count on them to say the right things even when I don’t want to hear it.”

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  • Monday, Tuesday, Thursday
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