If carrying responsibility for everyone else has left you feeling emotionally exhausted, you may also find our article on sandwich-generation caregiver stress helpful. It explores how caregiving across different stages of family life can contribute to overwhelm, burnout, guilt, and difficulty making space for your own needs.

Are You Part of the Sandwich Generation? Hint: It Is Not About Food

By Staci Makela-Kerr, MS, LPC Associate

You have probably heard of Baby Boomers, Generation X, Millennials, and Generation Z. But have you heard of the sandwich generation?

Despite the name, this is not the generation that grew up eating peanut butter and jelly sandwiches and later made friends with GLP-1 medications.

The sandwich generation includes adults who are raising or financially supporting their own children while also helping care for aging parents. They are “sandwiched” between the needs of two generations, often while managing careers, relationships, household responsibilities, and their own health.

That can mean taking a teenager to school in the morning, calling a parent’s doctor during lunch, helping a college graduate with rent, picking up prescriptions after work, and somehow remembering that you also need to eat dinner.

What Is the Sandwich Generation?

The sandwich generation is not one specific birth cohort. It describes a caregiving role that is especially common during middle adulthood.

Some people are raising young children while helping an aging parent. Others are supporting an adult child who is still financially dependent while coordinating medical appointments, transportation, finances, or daily care for an older relative.

The support is not always hands-on. It may be emotional, financial, logistical, or all three.

Why Are More Adults Feeling Sandwiched?

There is no single reason more adults find themselves supporting multiple generations. Several social, medical, and economic changes have combined to extend caregiving responsibilities.

The Emotional Weight of Caring for Two Generations

Being needed can feel meaningful. Many people genuinely want to support their children and parents.

But caregiving can also be exhausting, expensive, and emotionally complicated.

You may love your family deeply and still feel frustrated. You may feel grateful that your parent is alive and simultaneously grieve the changes you are witnessing. You may want to help your adult child while worrying that the support is preventing independence.

Opposing emotions can exist at the same time.

When the Parent-Child Roles Begin to Change

It can be difficult to remain someone’s child while also becoming the person who reminds them about medication, questions whether they should still drive, or discusses whether they can safely live alone.

A well-meaning adult child may sound controlling to an aging parent who has made independent decisions for decades. Meanwhile, the adult child may feel frightened, responsible, and unsure how to help without taking over.

This role reversal can create tension on both sides.

Three Skills That Can Protect Your Sanity

There may not be a perfect way to balance every responsibility. But boundaries, communication, and thoughtful planning can reduce confusion and help responsibilities feel more manageable.

1. Set Boundaries Before You Reach Your Limit

A boundary is the line that identifies what you can reasonably provide and where your limits begin.

It may mean learning to say no when you have always said yes. It may mean deciding that you cannot answer every call immediately, attend every appointment, solve every financial problem, or serve as the only person responsible for care.

A boundary can sound like:

Boundaries are not punishment. They are a way of keeping support sustainable.

2. Communicate Clearly and Directly

You cannot expect people to respect boundaries they do not know exist.

Having a thoughtful conversation is the first step. Let family members know what you can do, what you cannot do, and where additional help is needed.

Somewhere along the way, you may have learned that doing everything alone means you are strong, capable, or good. But asking for help can also be an act of strength.

3. Plan Before a Crisis Forces the Conversation

Planning does not create a medical emergency, financial problem, or loss of independence. It simply gives the family a starting point if circumstances change.

If your parents do not currently need much help, this may be the best time to ask what they would want in the future.

Look for Ways Family Members Can Help One Another

Not every responsibility has to flow through the person in the middle.

Perhaps your parent can help your teenager practice driving, share family stories, or assist with homework. An adult child living at home may be able to run errands, prepare meals, troubleshoot technology, or spend time with a grandparent.

These arrangements should not place inappropriate caregiving responsibility on children, but there may be safe and meaningful ways for family members to support one another.

Self-Care Is Not Another Task to Perform Perfectly

Self-care does not always mean a spa day, a weekend away, or several uninterrupted hours. Those things can be wonderful, but they may not be realistic during an intense caregiving season.

Sometimes self-care is smaller and more practical.

Signs You May Be Experiencing Caregiver Burnout

Caregiver stress can build gradually. Because you are focused on everyone else, you may not notice how depleted you have become.

These signs do not mean that you do not love your family. They may mean that your current level of responsibility is not sustainable without additional support.

When Therapy Can Help

Therapy can provide space to talk openly about emotions that caregivers often feel ashamed to admit, including anger, resentment, guilt, fear, grief, and relief.

Counseling may help you:

You Are Allowed to Be Part of the Care Plan

If any of this sounds familiar, you may be part of the sandwich generation.

Perhaps your parents still live independently but are finding certain tasks more difficult. Maybe you have a teenager at home who does not drive, an adult child struggling to find stable work, or a parent who has decided it is time to stop driving.

Learning to set boundaries can feel uncomfortable. Communicating differently may feel like learning a new language. Asking for help may challenge everything you were taught about strength and responsibility.

But you do not have to disappear inside your caregiving roles.

Your needs matter. Your health matters. Your relationships matter. Your rest matters.

Why You Don’t Feel Good Enough: Understanding Low Self-Esteem and Your Inner Critic

By Mia Zamora, LPC Associate

One of the most common concerns I see among the clients I work with is low self-esteem. Many people enter therapy believing they simply “don’t like themselves” or that they need to become more confident.

Confidence can certainly be part of self-esteem, but self-esteem runs much deeper than how capable or outgoing you feel in a particular moment. It includes the beliefs you carry about who you are, what you deserve, and whether you believe you are enough.

These beliefs usually do not appear overnight. They are often learned gradually through our experiences, relationships, and the messages we receive from the people around us.

What Is Self-Esteem?

Self-esteem is the overall way you evaluate your own worth and value. It affects more than whether you feel confident walking into a room or completing a difficult task.

Your self-esteem can influence how you respond to mistakes, what you tolerate in relationships, whether you advocate for your needs, and how you interpret challenges.

How Do Core Beliefs Shape Self-Esteem?

Many of the beliefs we carry about ourselves are what therapists refer to as core beliefs. These are deeply rooted assumptions we develop about ourselves, other people, and the world around us.

Core beliefs often begin forming in childhood and continue to be reinforced throughout adolescence and adulthood. They may come from parents or caregivers, siblings, coaches, peers, romantic relationships, social expectations, or repeated life experiences.

Sometimes these messages are communicated directly through criticism, rejection, bullying, or unrealistic expectations. Other times, they are much more subtle.

Maybe you learned that you had to perform well to receive praise. Perhaps your emotions were dismissed, leaving you with the impression that your feelings did not matter. You may have received attention mainly when you were helpful, successful, attractive, agreeable, or productive.

Over time, these experiences can shape how you begin to see yourself.

Where Does Low Self-Esteem Come From?

Meet Your Inner Critic

One thing I often ask clients to do is pause and become curious about their inner critic. We all have one to some degree.

Rather than immediately trying to silence it, I encourage people to first get to know it.

Is the Inner Critic Really Your Voice?

Many clients assume the inner critic is their own voice. They believe these thoughts represent who they truly are.

But as we begin exploring where these thoughts originated, we often discover something different.

More often than not, negative self-talk contains internalized messages that were repeated so many times they began to feel like facts. The critic may sound like a demanding parent, an unhealthy relationship, a former teacher, societal expectations, or years of comparing yourself to everyone else.

Eventually, those outside messages become internalized. Without realizing it, you may begin speaking to yourself the way others once spoke to you.

Your Thoughts Are Learned Patterns, Not Automatic Facts

That small shift can change the way you relate to negative thoughts. It moves you from accepting them as truth to recognizing that they may be learned patterns of thinking.

Long-held beliefs can feel factual even when they are based on old experiences, assumptions, or distorted interpretations. Learning to identify and question them is an important part of building healthier self-esteem.

Externalizing Low Self-Esteem

In therapy, we sometimes refer to this shift as externalizing the problem.

Rather than viewing low self-esteem as a permanent part of your personality, you begin seeing it as something that developed through experiences and patterns. Because it was learned over time, it can also be examined, challenged, and changed over time.

You are not the problem. The pattern is the problem.

Common Signs of Low Self-Esteem

When Worth Becomes Conditional

Somewhere along the way, many people learned that their worth was based on achievement, appearance, productivity, or meeting other people’s expectations.

When those expectations are not met, the inner critic becomes louder and reinforces the belief that something is wrong with you.

This can create a painful cycle:

Healing self-esteem is not about becoming perfect or eliminating every negative thought. It is about building a different relationship with yourself.

Why Self-Compassion Matters

Self-compassion is something I discuss with many clients because it can feel unfamiliar. For some people, showing kindness toward themselves feels uncomfortable or even undeserved.

They worry that if they stop criticizing themselves, they will become lazy, complacent, or stop growing.

In reality, self-compassion does not mean avoiding responsibility or pretending mistakes do not matter. It means responding to difficulty with honesty, patience, and care instead of shame.

Research suggests that self-esteem and self-compassion can work together as protective factors for mental health. Self-compassion may also help people respond to setbacks without making their entire worth dependent on success or approval.

Inner Critic Versus Self-Compassion

Five Ways to Begin Strengthening Self-Esteem

A Reflection Exercise for Your Inner Critic

How Therapy Can Help With Low Self-Esteem

Therapy does not aim to turn you into someone different. It can help you understand the experiences that shaped your self-image and identify patterns that continue to reinforce self-doubt.

Depending on your needs, counseling may help you:

You Have Always Been Worthy

At the end of the day, you deserve to extend yourself the same love, care, patience, and grace that you so freely give to the people around you.

Therapy does not aim to make you someone different. It helps you uncover the version of yourself that may have been buried beneath years of self-doubt, unrealistic expectations, and critical self-talk.

My hope is that, over time, your own voice becomes louder than your inner critic—and that voice begins reminding you of something you have deserved to hear all along:

Why Many Black Americans Don't Seek Therapy: Breaking the Stigma Around Mental Health in the Black Community

By Jazzmine Kelly, MA, LPC Associate
Supervised by Dr. Aimee Rhodes, Ed.D., MS, LPC-S, CCTP

If you grew up in a Black household like I did, chances are mental health wasn't something your family openly discussed.

We talked about working hard. We talked about being strong. We talked about making it through difficult seasons. But conversations about anxiety, depression, trauma, burnout, or therapy? Those were much harder to find.

For much of my childhood, mental health simply wasn't part of the conversation. It wasn't until I became an adult that my own family started openly acknowledging that our emotional well-being matters just as much as our physical health.

As a Black therapist, I've realized this experience is incredibly common. Many of my clients share similar stories of growing up believing they had to "push through," "pray about it," or simply keep moving.

The truth is, mental health has always mattered. We're just finally giving ourselves permission to talk about it.

Mental Health in the Black Community: The Numbers Tell a Story

Black Americans experience anxiety, depression, trauma, grief, chronic stress, and burnout like anyone else. But research consistently shows that Black adults are less likely to receive mental health treatment compared to White adults, even when care is needed.

This gap is not about Black communities caring less about mental health. It is connected to stigma, access barriers, cost, historical mistrust of healthcare systems, discrimination, and difficulty finding culturally responsive providers.

Why Is Therapy Underutilized in the Black Community?

One of the most common questions people ask is, "Why don't more Black people go to therapy?"

The answer is complex because there isn't just one reason.

Mental health services have historically been underutilized by many Black individuals due to a combination of stigma, limited access to care, financial barriers, historical mistrust of healthcare systems, and a lack of culturally responsive providers.

Many of us were raised believing emotional struggles were something to overcome privately rather than something worthy of professional support.

These phrases often came from places of love and resilience. Our parents and grandparents survived incredibly difficult circumstances, often without access to mental health care themselves. They taught us the coping skills they knew.

But surviving is not the same as healing.

Mental Health Stigma Doesn't Mean People Don't Care

Mental health stigma is often misunderstood. It does not mean families do not care about emotional pain. More often, stigma develops when generations of people have had to survive adversity without access to emotional support, safety, or culturally responsive care.

For many Black families, being strong was not just a personality trait. It was a survival strategy.

But strength can look different now. Strength can include rest. Strength can include asking for help. Strength can include naming what hurts instead of pretending everything is fine.

How Untreated Stress Can Show Up

When anxiety, depression, grief, trauma, and chronic stress go untreated, they rarely disappear. Instead, they often show up in our bodies, relationships, work, and daily functioning.

Barriers to Mental Health Care for Black Americans

Stigma is only one piece of the puzzle. Many Black individuals and families also face practical barriers when trying to access therapy.

Historically, Black communities have experienced significant disparities in healthcare access. Families may encounter financial hardship, limited insurance coverage, fewer nearby mental health providers, transportation challenges, childcare barriers, or work schedules that make regular appointments difficult.

Just like we visit a physician when our bodies need attention, we deserve support when our emotional health is struggling.

Historical Mistrust of Healthcare Systems

For many Black Americans, mistrust of healthcare systems did not appear out of nowhere. It is connected to generations of medical racism, discrimination, unethical treatment, misdiagnosis, and unequal access to quality care.

Even today, many Black clients worry about whether they will be believed, respected, understood, or unfairly judged when seeking medical or mental health support.

That history matters. It is one reason culturally responsive care is so important.

Why Representation Matters in Therapy

One question I hear often is, "Does it matter if my therapist looks like me?"

The answer is different for everyone.

Some people do not have a preference, while others specifically seek a Black therapist or therapist of color because they want someone who understands parts of their lived experience without needing extensive explanation.

Representation matters because culture shapes how we experience the world.

As a Black therapist, I know how validating it can feel when clients do not have to explain concepts like code-switching, racial stress, generational expectations, or the pressure of constantly having to be "strong."

That does not mean therapists from different backgrounds cannot provide excellent care—they absolutely can. But having more diversity within the mental health profession gives clients more opportunities to find someone they naturally connect with.

Therapy Is More Than Treating Mental Illness

Many people think therapy is only for individuals experiencing severe depression or a mental health crisis.

That simply is not true.

Therapy can help you build tools, understand patterns, improve relationships, process pain, and create a healthier way of living.

You do not need to wait until everything falls apart before asking for support.

What to Expect From Your First Therapy Session

If therapy feels unfamiliar, it is normal to feel nervous before your first session.

A first therapy session is not about being judged, criticized, or forced to share everything at once. It is usually a conversation where your therapist gets to know you, what brings you in, what you have been carrying, and what you would like support with.

You do not have to have all the right words. You do not have to know exactly what you need. You just have to start somewhere.

Breaking Generational Cycles Starts With One Conversation

One of the most rewarding parts of being a therapist is watching clients become cycle breakers.

They are teaching their children emotional vocabulary. They are modeling healthy boundaries. They are learning that asking for help is not weakness. They are showing future generations that healing deserves a seat at the table.

Every conversation about mental health helps reduce stigma.

Every therapy appointment helps normalize emotional wellness.

Every person who chooses healing makes it easier for someone else to do the same.

You Deserve Support

If you have been considering therapy but wondering whether your struggles are "bad enough," I want you to know this:

You do not have to earn the right to receive help.

You do not have to wait until you are in crisis.

You do not have to carry every burden by yourself simply because previous generations had to.

Seeking therapy does not mean you are weak. It does not mean you have failed. It does not mean you are abandoning your family's resilience.

It means you are choosing healing alongside strength.

As a Black therapist, I believe our communities deserve access to compassionate, culturally responsive mental health care. We deserve spaces where we feel heard, understood, and supported—not only during life's hardest moments, but throughout our journey toward growth.

Healing is not just about surviving. It is about creating a life where you can truly thrive.