- The Mental Fitness Podcast
- Episode 53
The Mental Fitness Podcast•Episode 53•52 min
Rough Patch or Something More: How to Tell When Your Mental Health Needs More Than Practice
September 1, 2026
Dr. Karen Manotas, a child and adolescent psychiatrist, explains why sudden changes are easy to catch and gradual ones are not, and how to tell when practice is no longer enough on its own.
Follow the podcast on Instagram and TikTok for one idea from every episode.
Read the articleHow do you know if what you are feeling is a real problem or just a rough patch?
Dave and Luke sit down with Dr. Karen Manotas, a child and adolescent psychiatrist who left traditional practice to build school-based mental health care across Utah. Her work has taught her something most of us would rather not hear. Self-awareness has limits, and those limits show up exactly where we need them most.
Chapters
- 00:00 Meet Dr. Karen Manotas. Dave and Luke introduce Dr. Manotas, who shares her story of leaving traditional psychiatry to build school-based mental health care across Utah.
- 05:08 The Surprising Truth. The pressure carried by teachers and school staff, and the generational shifts in how kids handle stress.
- 14:02 Spotting the Slow Signals. Why gradual changes are so much harder to notice than sudden ones, and the warning signs worth taking seriously.
- 30:01 When to Seek Professional Help. How to ask for help, how to check in with a friend who is struggling, and the eleven year average gap between symptoms and treatment.
- 41:37 What Is Mental Fitness? Dr. Manotas gives her own definition and points to where people can turn when the need arises.
Links and Resources
- Karen Manotas, MD | University of Utah Health
- Suicide and Crisis Lifeline, call or text 988
- Crisis Text Line, text HOME to 741741
- SAMHSA National Helpline
- Sign up for NUE: Your Mental Fitness Platform
- ElizaChat: Responsible and Ethical AI Solutions
Connection to Self•10 min
A Hard Month Can Become Your Baseline Without You Noticing
Read the articleMore episodes

Guest Interview•49 min
Paper Plates, Dogs, and Peers: What 130 People Taught a Harvard Psychiatrist About Mental Health

Connection to Self•46 min
Don’t Fix Yourself, Create Yourself: The 14-Day Self-Experiment for Mental Fitness

Guest Interview•51 min
You’re Not Stuck With the Brain You Have | Dr. Steven Storage on Mental Fitness

Connection to Self•54 min
Why Do I Keep Doing This? The Agency Reset for Habits You Don’t Even Enjoy Anymore