Your Mental Health: How to be your best, when you’re just not feeling your best
November 19, 2024 | Episode 29
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Dr. Gspandl, Marcus Thorpe, Lindsey Gordon
Lindsey Gordon 00:14
The holiday season can be filled with joy, family togetherness and yes, stress when you add that last variable in it can really be tough to pull yourself out and get back into the spirit of the season. And in some cases, people can experience severe depression. Some of the topics discussed today may be difficult to hear. With that, let's begin The Wellness Conversation an OhioHealth Podcast. I'm Lindsay Gordon.
Marcus Thorpe 00:39
And I'm Marcus Thorpe. On top of that, you have some pretty cloudy days, not much sunshine here in Ohio. So how do you pull yourself out of the blues, or maybe something that might be a little bit worse, it is a very important topic we have Dr. Scott Gspandl, OhioHealth, Director of outpatient behavioral health, with us. It's good to have you here. Thanks for joining us.
Dr. Gspandl 00:57
Happy to be here. Thank you.
Lindsey Gordon 00:58
Dr. Gspandl we all have tough days. I think we can all relate to when we have moments of stress. How do we know, though, when it's something more, maybe something that we need some help getting through?
Dr. Gspandl 01:13
Excellent question. I want to start off to anyone listening to this, to know that just simply being alive and awake every day is stressful. In fact, our brain sends signals to our adrenal glands to start secreting cortisol about an hour to two hours before we wake up. In preparation, cortisol is our primary stress hormone, just in preparation of waking up. Because as we all know, you wake up and the day starts, you have kids to get ready, work, to go to, a test coming up, countless things can come up throughout the day, and being alive is no small feat. I mean, you have to procure US dollars so that you can have shelter and food and support your loved ones. It doesn't always go as planned. There are challenges at every turn, and to feel stressed out and down and discouraged at time is very normal thing. And, you know, it's a good question, when should you reach out for help, when she know that it's something more? And I want to kind of let everyone know first of all, that it's okay to reach out anytime you feel you need help, as with any problem in medical care, it's always easier for us to address it if somebody approaches us sooner rather than later, whether it's with blood pressure, sugar, cardiac disease or depression or anxiety or stress, you can oftentimes reverse or address some of the things that are leading you to feel that way before our brains and our habits start to make that our default reaction every day and so, kind of just in summary, anytime is an appropriate time. From a clinical perspective, we have this notion in our diagnostic manual that essentially says, anytime a person has significant functional impairment in their life, i.e. their ability to function at work, interpersonally, school, those are our times. You really want to reach out for help.
Marcus Thorpe 03:24
We're to get a little bit more deep into kind of blues versus depression, versus anxiety and all those things. But another thing that a lot of people have to worry about, especially here in central Ohio, where we are, at least in Columbus, is those endless cloudy days during the late fall and winter and even early spring, where you just are begging for a little slice of sunshine or something that will help, kind of get things going. Seasonal Affective Disorder is a very real thing. It can really impact people. What have you seen and heard from the patient population when it comes to, this is difficult time of year for a lot of people?
Dr. Gspandl 04:01
And so one way to conceptualize depression or anxiety is to look at it almost as a holistic model of brain function. So when all of us are born, we're dealt a hand genetically determines what we're at risk for, be it cancer, heart disease, diabetes, depression, anxiety and different factors can either trigger the expression of those problems or worse, or prevent them from developing. We know that the seasonal changes have significant impacts on how our brains function is, you know, if you take a look at how our normal physiology is, we're not we're not organized to be nocturnal creatures. You know, we would do very poorly living our life.
Marcus Thorpe 04:54
A teenager would say differently.
Dr. Gspandl 04:56
Yeah, but we see much higher rates of depression and anxiety in the countries or regions of the world that have much longer periods of darkness, Iceland, Alaska, Pacific Northwest, other places around the world, because something about those states, trigger, you know, potentially trigger people who are genetically susceptible, or this, anybody and so, so that's just one of the many factors in in Ohio, for instance, it maybe isn't always just the seasonal changes, but some of the behaviors that accompany the change in season. So for instance, if I finish work at five, maybe it goes a little bit later. At six I'm driving home, it's already dark out, I might be convinced that, hey, the day is over. There's no sense to meet up with friends. There's no sense in going out to dinner. Maybe I just stay inside and actually have less connection with people, or feel less motivated to because biologically, I've been conditioned to when it gets dark out, to get ready for kind of getting ready for bed or winding down for the evening. And so that's something that can be quite helpful for folks, is that have a plan going into the season, especially they know that they're susceptible to this is to say, Hey, I know the months of you know, November, December, January, February, March, I start to feel worse, and I need to deliberately put stuff on my calendar to make sure that those behavioral patterns don't manifest again, where I become feel less connected and less intertwined with my community.
Lindsey Gordon 06:33
I was just going to ask, yeah, how important is that connection piece? I feel like I fall into that category of people who want to just put sweats on, be a couch potato, fold my laundry and get ready for the next day, set the coffee timer, boom, I'm good. Like, do I really need to be meeting up with friends or making an effort to do that? Is it really beneficial to our health overall, our mental health?
Dr. Gspandl 06:59
More than ever. We live in a society now that I don't know that our brains were adapted to live in where things have become so easy to convenient that I can have Amazon, I can desire something and have Amazon delivered to me that day, overnight, or the next day at the latest, and that cuts out the opportunities for social connection that you otherwise would have gotten, going to the grocery store, going to the deli, interacting with folks at Target or the store, all these things that we know our brain has been conditioned to be very good at and have a lot of positive rewards interacting with people. The advent of social media has amplified this as well. Where we are, on paper, more connected than we've ever been, but actually less connected than we've ever been, and so you end up having to be go out of your way to set aside time to meet with people. I know that, you know, men's mental health is a big topic as well, because men are very general on the whole, very bad at doing this. You know, they tend to need some activity to coalesce around, to spend time together, where it's less appropriate for them to just say, hey, do they want to come get together at my house to spend time together? And there needs to be a sporting game, a sporting match or involved in some sport, or something like that.
Marcus Thorpe 08:26
We know this time of the year kind of a holiday push stress, maybe some financial challenges or struggles. It can really hit the brain. It can really hit the body. Why is it that all of this stress can really pile up, and before you know it, you feel like you're drowning in a lot of those cases, right?
Dr. Gspandl 08:46
Absolutely. Going back to this model of a brain that is even more or less susceptible to developing these problems, again, a lot of that is determined by your genetics, but a lot of is also determined by your environment, because your brain is not a static organ. It is always changing in response to what's going on. Imagine that you're going to give a big speech in front of a lot of people or take a test, you would expect your heart rate to start changing. You might start sweating, breathing faster. These are all biologic changes that are driven by your brain perceiving a change in your environment, and so around the holidays, when there are a lot of unusual stressors that you don't necessarily get throughout the year, maybe coming together with family members who maybe you don't always quite get along With, and the conversations can become tense. There are expectations that people put on themselves, things like, you know, I have to get this present or things need to go just so anxiety at its core is our brains really wanting an outcome to happen yet there being uncertainty about it happening. And no matter how much we spend, there's no guarantee that things are going to go the way that we hope that they go.
Lindsey Gordon 10:09
I think it's important to go back on a podcast we had last year about glitter amid the grief. You know, Grief can be a heavy thing for a lot of people, any time of year, but then under the lens of this time of joy, when people are supposed to be festive, or getting ready for Thanksgiving and other gatherings and all these things, if you're dealing with grief and you just don't feel like celebrating these occasions or holidays, or you know, maybe you just lost someone, or you know someone who did, how can you navigate that, or if you know someone who's going through it, how can you support them?
Dr. Gspandl 10:45
So everybody grieves in a different way, and it takes people different lengths of time, and no amount of time is right or wrong, no method is right or wrong. It's a highly individualized process. And so the holidays tend to be very challenging for a lot of folks, especially as they've seen loved ones pass away. And that can be contrasted with people who are really enjoying the holidays and are in the festive mood, and that tends to kind of amplify things for folks, one way that that think we can be supportive of those people who are struggling is to realize it's okay to reach out and let them know. Hey, we'd love to see you. You're welcome to come by anytime, because we all tend to want a lot of the same things in this world, and that's to feel included and wanted, supported and loved, and you can never really go wrong as a family member or a friend by reaching out to someone maybe that you haven't heard from in a while. We get going back to our earlier discussion of social media, it's easy again to feel like, hey, I'm connected with this person, when maybe I haven't actually talked to them six months a year or so. And it's it takes me 10 seconds to maybe reach out to someone I haven't reached out to in a long time, but then I come up with all these excuses about why it's too time consuming, or I don't have the time to do that so, so just some general principles to kind of know is that it's okay to let people it's okay for them to say no, but it's never wrong To let them know that they're that they're wanted.
Marcus Thorpe 12:42
Yeah, continuing that reach out, sometimes you'll get a no, but sometimes it's that right moment where that person really wants you to ask, and they say yes, and make sure that they know that the door is always open for you to walk through if you need it. I love the concept of you know, when maybe you're wallowing in some challenging times in your life and you're really struggling. You can't always see it in yourself, but others can see it in you. Can you talk about being kind of that active eye or active friend, where you notice some real changes in somebody that you love or care about, and maybe you're the first line of defense of saying, hey, something seems off, or something seems wrong. Is there something going on and starting that conversation?
Dr. Gspandl 13:25
Keeping up appearances is such a thing that we've all been conditioned to do where we don't want to let anyone know that we're suffering. We're struggling. Heck, in fact, we'll create entire social media personas of ourselves to show how actually awesome we're doing, and how we're not suffering. And so it really does take, sometimes, someone who cares about you and who loves you to say, to say, hey, I've noticed this change. Are you okay? And there's different types of, you know, trainings that we'll do for folks in the hospital system that we're trying to roll out that that, you know, just help people who aren't necessarily embedded in the mental health field feel comfortable asking, hey, how are you doing? What can I do to help? These types of basic questions are things that someone might go months, years and is anyone actually asking them despite, to your point, Marcus, everybody, a lot of people close to them, knowing that something is going on.
Lindsey Gordon 14:30
Let's talk a little bit about medications and how they've played a big role in this space. But it's really a person by person basis. If you want to kind of talk a little bit about that, how do you know when you need help from medication? Is there still a stigma surrounding that?
Dr. Gspandl 14:45
Absolutely a stigma. And in this concept of our brain function, our brain is this miraculous organ that is responsible for heart rate. Right? Our lungs, expansion, contraction, what we think about, our memory, concentration, awareness of what's going on around us, what's real and what's not in our environment. So it's doing all of this all day, and we're only conscious of a small, small bit of what our brain is actually doing at every moment. If you know in medicine, when we're treating any organ in the body, you kind of look at, okay, what are my treatment options that are available to help this organ function better? So if somebody is seeing a cardiologist, and a cardiologist might recommend dietary changes, exercise, program, medications, therapy for stress reduction, and all these things would be very reasonable and individualized, tailored for that person's specific condition and their circumstances and who they are. Mental health is no different. If you're treating somebody for depression or anxiety or bipolar disorder, you kind of as a, as a physician, you know, I take a very thorough history and try to look at someone holistically and say, Okay, what interventions do I have available, psychotherapy, medication, changes in their environment so their relationships, family, friends, hobbies, diet, exercise, housing and kind of try to craft an individualized plan just for them. And medications might be a piece of that for mild symptoms, the recommendation generally is to consider, for instance, psychotherapy or medication, just whatever the patient prefers, both are reasonable options, and we kind of default to that in a lot of other fields as well for moderate to severe symptoms. Generally, the combination of therapy and medications tend to be recommended and given their evidence to help someone return back to living and enjoying their life and reducing symptoms.
Marcus Thorpe 17:00
We talk about stigmas with medication. I actually will say that I think in some cases, we've seen kind of a breaking down of stigmas, at least when it comes to having conversations about mental health. I think it's really heartening to see when celebrities step forward, and then maybe that gives people the green flag to say, well, if my favorite athletes going through something, then it's okay for me to talk about it. Or if my favorite actor is going through it, then maybe I can talk about that. Can you talk about that a little bit? I mean, how, how important has it been over the last couple years? Look, COVID was a terrible thing that a lot of people were going through some of those mental anguish things, but we are talking a little bit more about this, as evidenced by even this podcast itself.
Dr. Gspandl 17:44
Absolutely, absolutely. You know, my parents’ generation was extremely reluctant to discuss mental health with anybody, because at that time, there was these are folks who either had family members or knew of people who were hospitalized in asylums for long periods of time because of mental health condition. And so there's a lot of been a lot of trepidation about discussing this over time. I would say over the last 10 years or so, it's been there's been such an openness to discuss this, this aspect of our lives and our health care, and I think it's absolutely wonderful thing, is there still some progress to be made, absolutely but at the end of the day, these, these schemas that develop in our culture, take a very, very long time. Often, you know, decades to kind of fully change and that's okay. It's just you have to sometimes remind yourself of that when you're in it, because one day can look like the last can look like last year. But when you zoom out and see the big picture, probably you're absolutely right. Things have changed. And I think it's wonderful.
Lindsey Gordon 19:01
It's fascinating how you started this podcast talking about how everything in life is stressful, just living, waking up in the morning is stressful. And it's important to focus on your mention of connectivity and staying connected and social, and how that can really be a tremendous help, on many levels, to know that, yeah, it's, you know, just even validating knowing, life is stressful for this person too. It's not just me. As we sort of wrap this up and before we switch gears to a fun round to ask you some questions, to get to know you. What's your message to those listening? What message do you really want to drive home about when it's vital to seek help, get treatment, maybe even go to the hospital.
Dr. Gspandl 19:51
Suicide is often discussed as a preventable cause of death, because it is and in a lot of the vast majority. Operative instances. It is a highly preventable, premature death. The second leading cause of death is from CDC data from five years ago. The second leading cause of death from age 13 to 35 is suicide. It is, I believe, the leading cause of death in the postpartum period as well. And so this is the very much of my much of my job as a psychiatrist focuses on helping improve somebody's quality of life, but this is the part of my job that focuses on how to extend somebody's life, and those are really the two main reasons you would want to really ever see a physician, is to extend your life or improve your quality of life. It's the third being, bringing, bringing, bringing a new life into the world, you know, in terms of OB GYN care. So if somebody ever feels like they're in crisis, it's important to know that you know they're having suicidal plan, intent, desire, they aren't able to care for themselves. From a mental health perspective, their brain is having a harder time discerning reality from non-reality and their plan. Their brain is making plans that that are illogical or want to acting erratically. These are generally speaking, very temporary states that someone is in, usually suicidal intent and plan. Suicidal intent and drive can only last for sometimes minutes or hours. We tend to do a pretty good job of stabilizing somebody on an inpatient unit when it comes to that. And think sometimes people can have a misperception about what that actually looks like. Hey, I don't want to be locked in a hospital for weeks on end. That's just not, not the case. You know, the average length of stay in our average psychiatric hospitals anywhere from, you know, three, seven days or so. And so it's really trying to help someone get through that crisis period, make sure that we have outpatient linkage, said, you know, in place. And you know, it's never, never wrong to get evaluated if you if you feel that way, and if you feel like symptoms aren't to that degree, but you really need help. That's when it's very important to just let somebody know, be it an urgent care, primary care doctor, reaching out to a mental health professional in the community.
Marcus Thorpe 22:37
And we do want to share Central Ohio suicide prevention hotline number 614-221-5445, 614-221-5445, the National Suicide Prevention Lifeline is 1-800-273-8255, obviously, this is a podcast. If you need that number, you can always rewind and you can get more information on that. And we want to let you know that helps available. The 988, suicide and crisis Lifeline is also available, so plenty of options for people to really think about if they are going through some of that crisis, crisis moment. Watch out for your friends. Watch out for your family. Know that you're really not alone in this, right? Everybody's feeling a little bit blue here and there, and it's sometimes it's more than that, and that's when you really need to find some help, find some treatment.
Lindsey Gordon 23:19
So awesome. Yeah, definitely important stuff here. And Dr. Gspandl, we do always try to save a little bit of time at the end to end on a high note and get to know more about you and have a little fun. So you're ready for some fun-round questions?
Dr. Gspandl 23:34
Absolutely.
Lindsey Gordon 23:36
This has been very important information helpful for our listeners. For you as a doc, when you have someone you've treated, say, wow, I feel a lot better. What's that like for you? Like, what's the reward for you when you really help, you know, steer someone in the right direction?
Dr. Gspandl 23:57
First off, I feel, I feel so thankful that I get to do what I get to do, and aware of all the people that support what I do, because I wouldn't be able to do my job effectively if I didn't have teams of medical assistance and office managers, office specialists and folks who work at the facility to make sure that it's that it's clean and that things operate and financially make sense. Every person who works at OhioHealth is supporting the care that we provide, and I just am very fortunate that I get to be on the direct receiving end of some of that feedback, sometimes, because a lot of us have to, you know, just hope that we're doing something that is benefiting the community. And. I really, really enjoy getting to wake up and know that, you know, I'm helping, helping ease the suffering or ease the stress in other people's lives.
Marcus Thorpe 25:13
Yeah, just that hope of knowing that whatever you say that day could really make an impact for somebody. Look, you talk all day long. For a living. You're constantly hearing people at their sometimes worst and sometimes on their upswing best. So when you get home, are you just completely talked out and maybe just want to sit and watch TV or read a book, or you got young kids too, so you got to kind of balance that. But how do you unwind after those really stressful days, too?
Dr. Gspandl 25:40
So my kids don't care that I've been talking all day, and I prefer that way they have a lot to report when I get home, which is great.
Lindsey Gordon 25:51
You're a girl dad right?
Dr. Gspandl 25:51
Yes, yeah,
Lindsey Gordon 25:52
Chatty, chatty.
Dr. Gspandl 25:52
So they help. They help really support me mentally. I'm just getting to hear about their days and and watch them experience life and help them through it. I usually get about one to two hours at the end of the day where I'm not working, not taking care of kids, and try to allocate that time, you know, either exercising, you know, my wife, has an incredible support, and so it's good to really, really good to debrief with her on the day as well. I don't tend to read the stuff I do read tends to be related to work stuff, so I don't read for pleasure too often, but I do enjoy what I read about, and we like to watch those British dramas. I think that they are. They're very just say, you could tell someone spent a lot of time writing each episode, because they'll often only have a couple per season. So it's very high yield content.
Lindsey Gordon 26:58
What kind of Bedtime Stories did the girls like?
Dr. Gspandl 27:03
It's changed over the years. So we get new books from the library every week, and we kind of cycle through those. But we've had to shorten the bedtime routine. I had somebody tell me once, never add something to the bedtime routine, because it's very challenging to take it away. And so finally, we've gotten the bedtime routine to a very streamlined place. That's awesome. Doesn't take as long as it used to.
Lindsey Gordon 27:29
Yeah, oh my gosh, that's funny. We're really into the Gerald and Piggy books right now. Those are good. Yeah, they're Mo Willems. Is the author?
Dr. Gspandl 27:36
Yep, those are good ones.
Marcus Thorpe 27:37
I remember those well. Dr. Gspandl, thank you so much for your time, for your information. I know this will really help people. And again, that message of you're not doing this by yourself, you're not alone. There's other people that are out there feeling the same thing and those that can help you, I think, is really important. So thanks for your time. My pleasure. Well, we're all in this together. We are and we thank you for joining us for this episode of the Wellness Conversation an OhioHealth podcast. Before we wrap up, we invite you to follow us on all major social channels. We want to make sure you stay up to date on any new episodes, health and wellness topics that are coming your way. If you're looking for more information on OhioHealth services, including those in the mental health space, and also locations you can go to ohiohealth.com
Lindsey Gordon 28:14
The information in this episode will also be available in written form on the podcast page. Thank you for joining us, and be sure to subscribe as we continue our exploration of important health and wellness topics with OhioHealth experts.