258. why you never feel good enough (even when you're doing everything right) dr. marisa g franco

do you want to start therapy but are worried about what your parents might think? are your parents making you try therapy but you don’t know what to expect? whether therapy is your idea or theirs, this episode breaks down why dialectical behavioral therapy (dbt) can help families navigate even the most challenging mental health issues (content warning for brief mentions of SH).  today’s guest is dr. jill rathus— a world-renowned authority on dbt. she co-developed dialectical behavior therapy for adolescents and families alongside dr. alec miller and dr. marsha linehan and is the co-author of several of the leading texts on this subject, including the widely used dbt skills manual for adolescents. in this episode, dr. rathus shares her expertise on a number of teen mental health topics, including how to tell if a teen is dealing with mental health issues and what steps a family can take to help. we talk about: 01:38 what an initial dbt appointment can look like 09:02 common concerns that teens + parents have about mental health 13:07 qualifying “normal” teen behavior vs. a mental health issue 18:39 why it often takes a crisis for teen mental health to be taken seriously 22:42 signs that a teenager is reaching out for help with their mental health 23:55 how to validate someone who’s struggling (+ common invalidating responses) 26:04 strict vs. lenient parenting styles + how that impacts teen mental health 28:53 starting family therapy + what that involves 35:55 applying therapy to daily life in ways that actually work 39:43 why dr. rathus is hopeful about teen mental health   mentioned: • dr. rathus’ bio • dr. rathus’ practice • dbt skills manual for adolescents • dbt skills manual for adolescents: second edition (preorder) • mclean 3east • wdbta summit 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected] © 2026 SHE PERSISTED LLC. all rights reserved.

if you know what you need to do to improve your mental health, but struggle to implement these changes into your life, then this episode is for YOU.  today’s guest is shireen rizvi— a licensed clinical psychologist who has conducted research and training in dialectical behavioral therapy (dbt) for over twenty-five years. in this episode, dr. rizvi and i discuss how to implement dbt skills into your daily life.   whether you’ve never heard of dbt before, or you’re a dbt expert, this episode isn’t just about learning the skills— it’s about figuring out how to actually apply them in your life. because while awareness is a crucial step in mental health recovery, it’s not the only step that matters.  we talk about: • what to do if you struggle to trust your emotions • safely navigating your most intense emotions • figuring out your “life worth living goals”  • getting motivated to make positive changes in your life • debunking common pushbacks against using mental health skills  • why dbt gives people more grace to make mistakes mentioned in ep #264: • dr. rizvi’s website • real skills for real life • marsha linehan’s books • wdbta summit • dbt skills sheets 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

are you currently at a low point with your mental health? do you hate it when people tell you “it will get better”— mostly because you don’t believe it ever will? in today’s solo episode, i’m answering the questions i had when i was struggling with severe depression and suicidality as a teenager. eight years after being hospitalized for my mental health, i’m looking back on the doubts and fears i had throughout my recovery and sharing what actually helped me get better. if you’re currently asking yourself questions like will i always feel this way? what if it’s not bad enough to deserve help? what if asking for help makes everything worse? then this episode is for you.  i talk about: 00:53 when i was hospitalized for depression at age 13 03:00 what to do if you’re feeling hopeless about your future 07:30 how i started to shut down my suicidal thoughts 11:31 the mindset shift i made in residential treatment that changed my life 15:56 ways to make asking for help feel a little easier 22:31 my final advice for anyone who thinks it won’t get better mentioned in ep #263: IF YOU ARE IN CRISIS (via Nock Lab)... If you are thinking about harming yourself or attempting suicide, please tell someone who can help:  • Call 911 for emergency services (in the United States). • Call 988 (the toll-free 24-hour hotline) to reach a trained counselor. • Go to a hospital emergency room. Ask a friend or family member to be with you or help you make these calls or take you to the hospital. If you have a family member or friend who is suicidal, do not leave him or her alone. Try to get the person to seek help immediately from an emergency room, physician, or mental health professional. Take seriously any comment about suicide or wishing to die. Even if you do not believe your family member or friend will actually attempt suicide, the person is in distress and can benefit from your help in receiving mental health treatment. 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

want to hear an expert’s opinion on the teen mental health crisis?! today’s guest is dr. blaise aguirre—an assistant professor in psychiatry at harvard medical school in the department of psychiatry. he is a child and adolescent psychiatrist and the founding medical director of the 3east dialectical behavior therapy continuum of care at harvard affiliated mclean hospital.  in part two of last week’s conversation, dr. aguirre reflects on his 25 years of experience in the treatment of mood and personality disorders in adolescents to share what teens in 2026 are struggling with most. he also shares actionable steps that gen z can take to improve their mental health– ranging from residential treatment to social media and ai use! if you want to make changes with your mental health, this episode will remind you that you’re not alone– while also providing you with actionable steps you can take to build your life worth living.   we talk about: 01:40 whether residential mental health treatment is the right choice for young adults 04:35 red flags to avoid when choosing a mental health treatment option 07:20 how teen mental health has changed (and stayed the same!) over time 09:55 pros + cons of using ai as a mental health resource 14:50 the role of social media in today's teen mental health crisis 19:05 mental health advice that every young person needs to hear mentioned: • part 1 with blaise • blaise’s first episode • @blaisemd on instagram • blaise’s books • 3east at mclean hospital 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

why are some people afraid to ask for help, even when their mental health is getting WORSE?! today’s guest is dr. blaise aguirre—an assistant professor in psychiatry at harvard medical school in the department of psychiatry. he is a child and adolescent psychiatrist and the founding medical director of the 3east dialectical behavior therapy continuum of care at harvard affiliated mclean hospital.  in this episode, i’m reuniting with dr. aguirre to discuss how my treatment at 3east saved my life– and why this program worked for me when nothing else did. dr. aguirre also draws his clinical expertise to unpack all things teen mental health, breaking down topics including self-hatred, agency, family dynamics, & more!  whether you’re struggling with your mental health or love someone who is, this episode is your guide to what makes treatment actually work.  we talk about: 03:27 what makes teenagers more likely to accept help for their depression 08:57 finding agency as a teen in inpatient treatment  12:52 why mental health challenges aren’t an intelligence issue 17:13 the role of self-hatred in depression  20:38 how depression can impact our relationships  23:40 what really motivates us to change our worst habits  mentioned: • dr. aguirre’s previous episode • dr. aguirre’s instagram • dr. aguirre’s books • mclean 3east 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

if you want to learn more about how our generation can create lasting change in mental health, this episode is for you! today’s guest is hailey hardcastle—a gen z mental health advocate who helped pass landmark legislation in oregon allowing students to take mental health days off from school. she was honored by teen vogue as one of the "21 under 21: young women changing the world," and her ted talk on student mental health has been viewed more than 4 million times. fun fact: this episode was recorded live at the active minds 2026 mental health conference—the nation’s leading mental health conference for young adults! during this conversation, we discuss our personal mental health journeys, how hailey’s advocacy helped turn an idea into a state law, the most effective ways to advocate for gen z mental health, and so much more– including answering audience questions!  we talk about: 1:52 why hailey became a mental health advocate at a young age 4:50 how she helped passed a bill allowing student mental health days 7:34 effective ways to open up to your parents about your mental health 12:44 what stops people from asking for help with their mental health 19:04 maintaining our mental health as adults vs. as teens 21:50 the future of mental health policy + advocacy 23:54 advice for people wanting to become mental health advocates 25:22 finding local mental health advocacy opportunities 27:10 what motivates us to speak up about mental health 29:06 tips on pushing forward mental health legislation mentioned: • hailey hardcastle • hailey’s ted talk • active minds • mental health conference • house bill 2191 (student mental health days)  🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

i’ve recently made a big career change and learned a LOT about my mental health along the way… so let’s talk about it!  in this solo episode, i’m explaining what sparked this transition in my life & how i’m planning on optimizing this period of change to improve my routines, habits, and overall mental health.  so, if you’re also going through a major life shift in your 20s– or are wanting to figure out whether you should take the plunge into a new chapter of life– here’s how to do so while optimizing your mental health! i talk about: 1:52 the career shift i’m making & why! 12:56 my advice for college students & post-grads facing career uncertainty 14:47 why new beginnings are the perfect time to work on your mental health 15:57 mental health areas i’m prioritizing in this new season of life 22:42 staying motivated as a post-grad (vs. as a college student) 26:04 a mindset shift for improving your mental health habits 29:25 defining what makes my life worth living 31:22 journal prompts for goal-setting, career planning, & more!  mentioned: • succeeding as a psych major (pt. 1) • succeeding as a psych major (pt. 2) • dr. angela duckworth’s episode • mental health book club episode • how to change 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

how can someone have high self-esteem but low self-worth??! today’s guest is dr. marisa g. franco— a psychologist, author, professor, and friendship expert. she writes about how to build relationships with yourself and others for psychology today and has been a featured connection expert for major publications like the new york times, the telegraph, and vice. in this episode, we continue last week’s conversation on self-worth and relationships. this time, we’re focused on the internal factors behind self-worth, such as your emotions, identity, and more! we talk about: 2:11 why it can be easier to validate someone else's feelings instead of our own 3:28 the two different types of self-esteem (& which one leads to better relationships) 5:04 how to process your emotions to improve your self-worth 7:10 why gaining self-worth can change your life for the better 8:26 ways we reinforce our insecurities without even realizing 12:58 pushing back against our own (& other people's!) insecurities 16:08 misconceptions about self-worth 17:06 if gen z struggles with self-worth more than other generations mentioned: • dr. franco’s previous episode • dr. franco’s instagram • dr. franco’s website • pre-order worth 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

why do some people struggle to accept love?? today’s guest is dr. marisa g. franco— a psychologist, author, professor, and friendship expert. she writes about how to build relationships with yourself and others for psychology today and has been a featured connection expert for major publications like the new york times, the telegraph, and vice. in this episode, we talk about how our self-worth impacts our ability to love ourselves– and receive love from others.  we talk about: 01:38 how self-worth and relationships are tied together 05:16 how you can be loved but not feel loved 06:16 how memories become the database of your self-worth 08:50 external vs. internal validation 10:10 how to rewrite the memories that shaped you 14:20 supporting someone who can't accept your love 15:38 low self-worth and feeling misunderstood 18:46 how i found 1% of hope in recovery 20:50 what we get wrong about attachment styles 26:02 the one thing to take away from this episode mentioned: • dr. franco’s previous episode • dr. franco’s instagram • dr. franco’s website • pre-order worth 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.

wanna know what over a decade of therapy, a psychology degree, and my own podcast have taught me about mental health?! in this solo episode, i’m breaking down the key takeaways that i’ve learned throughout my mental health journey. in honor of it being mental health awareness month, i’m condensing everything i’ve learned from receiving intensive mental health care and years of dbt therapy as a suicidally depressed teenager– combined with my psychology education at upenn and my experience creating this very podcast– to make your 12-step guide to maintaining your mental health. by the end of this episode, you’ll know all the mental health tips + tricks i wish i’d known when i was struggling! i talk about: • why avoidance is impacting your mental health  • how to start getting better at recognizing your emotions • my mantra for dealing with conflict more effectively • relationship changes + how to navigate them  • the power of secondary emotions  • effective ways to reach your goals + stabilize your mental health • a mental health quote that changed my life • an underrated aspect of managing your mental health  • whether we can use our mental health to predict our futures • the mindset that was stopping me from building a life worth living • how distraction can actually save lives • what i learned in therapy that changed my self-esteem forever mentioned:  • atomic habits • dr. blaise aguirre episode 🍿 subscribe on youtube 💌 ask me a question or leave feedback on the podcast! @shepersistedpodcast shepersistedpodcast.com [email protected]  © 2026 SHE PERSISTED LLC. all rights reserved.