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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Thursday · 49 min
Allan Houston and Tamara Houston: What Does Radical Acceptance Look Like At Home
Send us Fan Mail A hospital discharge can look like “problem solved” on paper while a family is still staring at the real question: where does our loved one safely go next? We sit down with Allan and Tamara Houston for a candid, grounded conversation about opening their home to Tamara’s sister Jill during a crisis, while raising seven kids and trying to keep their household steady. What unfolds is a rare look at family caregiving that is both tender and practical. We talk about the moment the decision stops being “should we help” and becomes “how are we going to do this,” plus what it takes to prepare children for a major change without fear or secrecy. Tamara explains why a family meeting mattered, how they set expectations, and how they made space for Jill’s recovery while keeping their kids’ comfort a priority. Alan shares what it feels like to recognize the gaps in mental health care and to learn, in real time, what support Jill was not getting before. We also dig into the nuts and bolts caregivers live with every day: transportation, appointments, coordination across systems, and the power of asking for help with specific requests. Along the way, we come back to a phrase that captures the heart of mental health caregiving: radical acceptance, paired with firm boundaries that protect everyone involved. If you’re navigating schizophrenia, developmental disabilities, crisis planning, or long-term family caregiving, this conversation offers a clear path forward: love, acceptance, and hope, backed by real support. Subscribe, share this with someone who needs it, and leave a review with the one takeaway you’re bringing into your own home. SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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Tuesday · 3 min
#5 Companion If You Say Calm Down, We Fight
Send us Fan Mail Your nervous system can’t “just calm down” if it’s still scanning for danger. We do a midweek unpack of our conversation with Danielle Worthen Cullenberg, and it’s one of those talks that puts words to what so many neurodivergent and sensory-sensitive people feel every day: the body stays on high alert long after the immediate threat has passed. We dig into “neurospicy” brains, sensory overload, trauma, and the invisible weight of caregiving pressure, then connect the dots to real-life patterns like vigilance, shutdown, avoidance, and control. Instead of treating dysregulation like bad behavior or a character flaw, we talk about nervous system regulation as a learnable process starting with awareness. The simplest shift is also the hardest: stop demanding calm and start getting curious about triggers, environments, and needs. We also share a practical tool to help you put this into action, including a nervous system map that helps you catch early signals before you hit a breaking point, and prompts that explore what changes when stress becomes the atmosphere of a home. One of the biggest takeaways we keep coming back to is this: accommodations aren’t special treatment, they’re often the reason participation is even possible. If anything here hits home, listen to the full conversation, try the Listener Action Guide, and then share it with someone who needs a gentler path to regulation. Subscribe, leave a review, and tell us: what’s the earliest sign your system is getting overloaded? DOWNLOAD THE FREE LISTENER ACTION GUIDE https://drive.google.com/file/d/1HrHl6opiJAKbvBoBvD4clhV92Q-6g1hi/view?usp=drive_link LISTEN TO HOLDING IT TOGETHER (KINDA) Spotify: https://open.spotify.com/show/2nobQzuuYVGKY9NYYWgcvO YouTube: Search for HITKINDA ADDITIONAL FAMILY AND CAREGIVER RESOURCES Care Coalition Journal: https://guardian-academy.thinkific.com/courses/CareKeeperJournal Mental Health Resource Network: https://www.facebook.com/groups/1296747162391859 Care Coalition: https://carecoalition.org/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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September 24 · 58 min
Annette: A Mother Learns That Survival Is Not The Same As Living
Send us Fan Mail Severe mental illness can turn a household into a command center overnight. One day you’re parenting, working, and planning for the future. The next day you’re tracking symptoms, bracing for outbursts, negotiating with hospitals, and trying to protect the people you love while you quietly disappear inside the role of “crisis manager.” We talk with Annette, a mother who lived that reality for years as her son’s behavior escalated from early warning signs to frightening instability complicated by substance use. We get specific about what families rarely say out loud: the isolation, the financial and career sacrifices, the exhausting search for effective therapy and psychiatric medication combinations, and the toll on siblings and marriage. Annette shares how her younger son carries real PTSD from growing up in the blast radius, and why boundaries in adulthood can be both heartbreaking and necessary. Then we focus on what helped: building a coordinated care team, setting realistic expectations about the mental health system, and documenting a clear timeline to find a baseline and measure change. Most importantly, we talk about what happens after the crisis loosens its grip. Annette describes returning to creativity, rebuilding purpose, and growing Towny Swag into a business and storefront that represents joy, identity, and forward motion without denying the past. If you’re supporting a loved one with severe mental illness, you’re not alone and you’re not failing. Subscribe, share this with someone who needs it, and leave a review with the one takeaway you want more families to hear. www.TownieSwag.com Historic town square. A ridiculous urban legend. The hole-in-the-wall ice cream shop where all the kids hung out. Or simply the eccentric old lady at the end of the street... There’s a lot of intrigue sprinkled into the towns of America. If you had the pleasure to live in (or endure) one of these delightfully distinctive ‘burbs, there’s an element of pride rooted within, whether you’re a transplant or a permanent resident. TownieSwag invites you to celebrate your hometown roots with gift items (including totes, pillows, tea towels, aprons, bottle bags, and more) that showcase the local character only true Townies ‘get.’ Your Roots. Your Town. Your Swag. SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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September 22 · 4 min
#4 Companion: Youth Mental Health Without The Fixes
Send us Fan Mail Most adults want to help kids who are stressed, anxious, or shutting down, but we often reach for the fastest fix: another app, another framework, another lecture delivered with good intentions. This midweek unpack slows that impulse down. I’m looking back at our conversation with five young people (ages 13 to 23) who spoke plainly about mental health, school pressure, performance expectations, and what it feels like to live under the constant mirror of social media. What stood out then still stands out now: young people aren’t problems to be managed, and they’re not checklists to complete. They want to be seen as whole people. They want a real voice in decisions that affect them. And they want support that doesn’t come with embarrassment, shame, or a requirement to “perform” wellness. We talk about why presence and trust often matter more than programmatic solutions, and how listening without interrupting can be a turning point for a teen who feels boxed in by pressure. To make this practical, we also share a new printable action companion built for that youth perspectives episode. It’s short, easy to use, and designed to help young people, parents, and educators reflect on what resonated and try a simple next step. Inside is a seven-day plan that starts by naming one pressure or “head trash” message you’re tired of carrying, then choosing one person who lets you be real without performing. Listen to the episode, grab the action guide through the link in the description, and if it helps, share it with a parent, teacher, or teen who could use more connection and less pressure. Subscribe and leave a review so more families can find this work. DOWNLOAD THE FREE LISTENER ACTION GUIDE https://drive.google.com/file/d/1HrHl6opiJAKbvBoBvD4clhV92Q-6g1hi/view?usp=drive_link LISTEN TO HOLDING IT TOGETHER (KINDA) Spotify: https://open.spotify.com/show/2nobQzuuYVGKY9NYYWgcvO YouTube: Search for HITKINDA ADDITIONAL FAMILY AND CAREGIVER RESOURCES Care Coalition Journal: https://guardian-academy.thinkific.com/courses/CareKeeperJournal Mental Health Resource Network: https://www.facebook.com/groups/1296747162391859 Care Coalition: https://carecoalition.org/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E6
September 17 · 58 min
Reclaim Calm in the Chaos: Time Mastery with Walt Hampton
Send us Fan Mail What if “busy” is the shield that keeps you from what you most need? We sat down with Walt Hampton—executive coach, author of The Power Principles of Time Mastery, and long-distance runner—to rethink time, energy, and the stories we tell ourselves about balance. This is a lifeline for caregivers, creators, and leaders who feel stretched thin and want a sustainable way to show up for others without burning out. We unpack the 80/20 principle and why a tiny set of actions creates the majority of your results. Walt shows how to identify your “one thing,” build a weekly plan tied to your core values, and use a 90-day focus to turn big goals into simple steps. You’ll hear how to set clean boundaries, craft a not-to-do list that actually sticks, and navigate seasons when family needs eclipse everything else—without abandoning your own oxygen mask. Habits are the bridge. We talk about anchoring new routines to existing ones, why discipline outlasts motivation, and how to clear “head trash” by starting with want-to and why before asking how. If your circle isn’t supportive, we explore finding accountability partners and communities that normalize your new standard. And yes, we reveal Walt’s favorite F-word: fun. Joy isn’t an add-on; it’s the fuel that makes focus, caregiving, and creative work sustainable. Walk away with practical steps you can use today: one microscopic habit to anchor, one boundary to draw, and one item to add to your not-to-do list. If you’re ready to do less, make more impact, and feel lighter while you do it, this conversation belongs on your calendar. If it resonates, subscribe, leave a review, and share it with someone who needs a gentler way forward. 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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September 15 · 5 min
# 3 Episode Companion Memory Is Not A Care Plan When Stress Hits
Send us Fan Mail Caregiving can feel like being the only person holding the whole system in your head and it’s exhausting for reasons most people never see. We unpack what happens when you’re expected to remember every detail, translate a loved one to rushed medical teams, and keep your cool while anxiety is doing laps in your body. If you’ve ever left an appointment and thought, “I should have said that,” you’ll recognize yourself here. We walk through a practical companion to “This Is What It Takes,” starting with the invisible caregiver loop: the tasks and worries that replay nonstop and eat up your working memory. Together, we talk about getting those responsibilities onto paper, then choosing what you can delegate, automate, or simplify using everyday tools. This is caregiver support that respects reality, not another impossible checklist. We also get specific about dignity-centered crisis planning: documenting baseline behavior, spotting early warning signs, and defining crisis thresholds before everything turns into an emergency. We touch on planning ahead for the “turning 18” shift around records access and decision-making, plus why an ER-ready summary sheet can change how fast a medical team understands what’s going on. Our bottom line is simple: memory is not a care plan, especially under stress. Listen, download the free PDF companion, and try one small action this week. If it helps, subscribe, share this with a caregiver you love, and leave a review so more people can find practical caregiving tools that actually work. https://michaelmackniak.org/free-listener-action-guides SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E32
September 10 · 47 min
Kala Allen Omeiza: I Got Bullied In An Autism Lab
Send us Fan Mail Watching someone succeed can fool us into thinking they’re fine. Then Kala Allen Omeiza says something that stops us cold: she worked in top autism research spaces and still didn’t learn she was autistic until 24, after a painful rupture, a mental health crisis, and therapy that finally connected the dots. We talk about what late autism diagnosis can look like when you’re a high achiever: sensory overload that gets dismissed, social communication gaps that get mislabeled, and the quiet burnout that builds when you’re always “passing.” Kala shares the irony of being bullied for autistic traits inside an autism research lab, and what it took to move from self-protection and academic distance to honest lived experience. From there we dig into her nonfiction book Autistic and Black, built from interviews with Black autistic people across a wide range of support needs, and the Kwanzaa principle Ujima, collective responsibility. We also map the real-world gaps in mental health care across the US, the UK, and Nigeria, from cost barriers to long waitlists to severe shortages of psychiatrists and the way stigma can turn crisis into a “spiritual” problem instead of a healthcare one. Kayla closes with what she’s building through I’m Heard Incorporated and why family-level support has to be the next frontier. If you care about autism, neurodiversity, mental health access, suicide prevention, and building systems that actually listen, hit play. Subscribe, share this with someone who needs it, and leave a review with the part that stayed with you. 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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September 8 · 5 min
Episode 2 Care Companion: You Can Love Them And Still Feel Worn Out
Send us Fan Mail Loving someone who is still alive but no longer feels like the person you knew can mess with your head in ways most people never see. On this midweek unpack of Holding It Together Kinda, I slow things down and revisit one of the most tender topics we have talked about: caregiver grief and ambiguous loss, the quiet, unacknowledged pain that shows up when memory, personality, and family roles change right in front of you. I reflect on my conversation with Dr. Joanne Schaeffer and the core truth that caregiver grief can start long before death. We talk about the emotional pile-up that so many caregivers carry in silence: love alongside anger, exhaustion alongside tenderness, resentment alongside devotion. I share why “two things can be true at the same time” is more than a comforting line, it is a practical way to stop judging yourself for having normal human reactions while navigating dementia caregiving, chronic illness, and long-term support needs. We also name the one feeling people whisper about but rarely admit out loud: relief when a crisis cycle ends. Feeling relieved is not evidence that your love is smaller. It is often your body finally leaving fight-or-flight, a nervous system response after months or years of high alert. I walk through a free Caregiver Grief listener action guide I built to go with the original episode, including prompts to name what you miss, honor what still matters, and choose one doable step for the next seven days so your brain can actually rest at night. Grab the free guide via the link in the description or at carecoalition.org, then listen, share this with a caregiver who needs it, and subscribe and leave a review so more families can find real caregiver support. What two emotions are you holding at the same time right now? https://michaelmackniak.org/free-listener-action-guides SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E31
September 3 · 1 hr 3 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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September 2 · 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E7
August 27 · 1 hr 12 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E17
August 20 · 1 hr 3 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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August 13 · 47 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E3
August 6 · 1 hr
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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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July 30 · 1 hr 1 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E12
July 23 · 1 hr 4 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E10
July 16 · 1 hr 5 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E9
July 9 · 1 hr 11 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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July 2 · 59 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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S1 · E11
June 25 · 1 hr 11 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 SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb 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/ SPECIAL ANNOUNCEMENT We are moving to a platform called Discord. Think of it as our own private, invite-only living room. JOIN HERE: https://discord.gg/2TCSdfNb I want to be there for you more deeply, but as many of you know, our private Facebook group hasn't been working. It became cluttered, it lacked real privacy, and it turned into a place for people to advertise instead of support one another. So, I have shut it down, and I’ve built us a brand-new, private home. There are no algorithms, no social media noise, and absolutely zero spam or advertising. I’ve set it up with a Free General Area where you can log in, pull up a chair, and just vent or chat with other caregivers who truly understand your day. There’s no video required—you don't have to worry about getting dressed up or what your house looks like. You can just listen in and talk to me like a private phone call. Now, if you aren't tech-savvy, please do not worry. I promise it is simple. I can’t wait to see you there, talk to you directly, and finally give you the supportive community you deserve. Now, let’s get into today's show." How to Join Our Private Care Community (Step-by-Step): Click this link: https://discord.gg/2TCSdfNb If you are on a phone, it will prompt you to download the free, secur...
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