Tools for Mental Health, Anxiety and Grief with Dr. Tash

What happens when a psychologist who specializes in helping families through with mental health suddenly finds herself on the other side of the table? In this episode, Dr. Natasha Poulopoulos (known as Dr. Tash) shares her deeply personal journey of losing her father to glioblastoma. We dive into the eerie quiet that follows a medical battle, anticipatory grief, and the science of the grieving brain.  

We also tackle the vast world of mental health and regulation. Dr. Tash explains why thoughts aren’t facts and how we can use cognitive diffusion to separate our identity from our anxious feelings. We discuss the critical difference between having a hard moment and having a clinical disorder, highlighting the power of behavioral activation—like movement and greenery—to shift our physiology and help us move through emotions in as little as 90 seconds.

Resources from this episode can be found at: https://www.fuelwitherin.com/podcast/v/episode-23-tools-for-mental-health-anxiety-and-grief-with-dr-tash 

CONNECT WITH DR. TASH:

Instagram | @dr_tashp

Website | https://www.drtash.com

FUEL YOUR PERFORMANCE

Momentous is my go-to for high-quality, science-backed supplements →

Offer: Use code FuelWithErin for 14% off one-time purchase and 35% off first-time subscriptions

Shop here: https://crrnt.app/MOME/1KeXpK4v 

LETS CONNECT:

Instagram | @fuel.with.erin

Youtube | @FindYourFuel

Submit a Story | https://fuelwitherin.com

==========

Disclaimer: The information provided in this podcast and its show notes is for informational and educational purposes only. It is not intended as medical advice or as a substitute for the advice of a physician or other healthcare professional. Using this information does not create a doctor-patient relationship.

Do not use this information to diagnose or treat any health problem or to prescribe any medication or treatment. Always consult with a qualified healthcare professional before making changes to your diet, exercise routine, or medications, or before starting any herbal or nutritional supplements. Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. The use of any information provided is solely at your own risk. This disclaimer also applies to any of the guests on the podcast.

Transcript

SPEAKER_00 0:00

We want to engage in what we call cognitive diffusion. We want to separate ourselves from the thought. You are not the thought of anxiety. You are a person who is experiencing an anxious thought. So there are studies that show that when we shift our language from I'm anxious to I'm feeling anxious because there's something inside of me that feels unsettled or I'm feeling anxious. That's different than I'm anxious, I'm an anxious person. The idea is over time, you're not responding as much to that anxious thought.

SPEAKER_03 1:02

But when her father passed away, she experienced that reality firsthand. In today's episode, we talk about navigating the grief process, tips for managing common health conditions like depression and anxiety, and strategies for improving mental health in kids.

SPEAKER_00 1:18

I'm Dr. Tosh. I'm a licensed clinical psychologist. I work in one of the nation's largest healthcare systems. I also see clients through part-time private practice, and I'm also a psychology consultant, meaning I help organizations develop better mental health protocols and create greater visibility about mental health in general. Within that, I do specialize in what's called health and pediatric psychology. So that really focuses on helping, supporting, and treating people who are experiencing things like depression, anxiety, adjustment issues, and just generally coping with a medical illness. For example, things like neurological diseases, solid organ transplant, diabetes, IBS, IBD. So really looking at the whole person and helping them cope with what's going on in their lives, whether that does include a medical illness or not.

SPEAKER_03 2:12

Awesome. I know one of the big drivers with your story was your own experience, living, being a doctor, and then also being a part of a patient's family with the experience with your dad. So curious if you could share a little on that.

SPEAKER_00 2:26

Yeah. I do work on the medical inpatient units, which can be pretty acute. So I work in things like ICUs on transplant floors, on transplant floors. And my experience is when my dad was diagnosed with a glioblastoma, which is the most aggressive brain tumor, which the research shows us it really has with treatment a survival rate about 12 to 15 months. And it is non-curable. So it's pretty dismal when you look into it. And when my dad was diagnosed with glioblastoma, I was in a situation where I work in a hospital. I help families cope with these new, very life-changing and devastating diagnoses. And here I am on the other side of the table where we're being given this diagnosis. And how do I continue to show up in my role as a psychologist? And how do I continue to show up for my family, to show up for my partner, just to show up in my daily life when I'm also as a person coping with this, what I would say both anticipatory grief, despair, and then eventually grief of losing him after he died.

SPEAKER_03 3:34

And so what was that process like in terms of, you know, you understand the grief process, and it might be helpful to re-go through that too, because I always remember some of the stages, but not all of them. Yeah. Um, and then I'm curious on your end of it, what was living it like after knowing what those are so well, but experiencing it yourself?

SPEAKER_00 3:55

Yeah, there are what people call the five stages of grief, which were developed back in the 1960s by psychiatrists, which great work and what we've seen over time is that we don't really stick to the five stages. Grief is so personal, it is so unique. And what we think about in mental health is that we we our grief is based on three things: who we lost, who we are, and how we lost them. So, really, our grief is a function of those components and it is a nonlinear process. So, another thing to keep in mind about grief is grieving is the long-term process that we go through after a tremendous loss. Grief are moments, I think they're more like acute bursts of strong emotional and physiological experiences. So someone may be grieving a lifetime, and within that, they have days that they're functioning and they're doing relatively okay. And then something like a smell, someone speaking about their loved one can bring this acute moment of grief. So I try to differentiate those two things for people.

SPEAKER_03 5:02

I'm so impressed with anyone in healthcare and the medical field who live this every day and are such amazing humans to support and foster humans and life and then dealing with death and grief. And so I'm just in awe of the situation that you're in to be able to deal with all those things. So curious like, where did your brain go? How did you manage?

SPEAKER_00 5:25

Yeah, I think for for me personally, right? Because grief is so personal. For me, my anticipatory grief was one thing, and then my now grieving and moments of grief after losing my dad are very different. So for me, anticipatory grief was a lot of anxiety, a lot of stress, a lot of pressure, a lot of agitation and frustration and constantly doing things for my family and for our dad to give him dignity throughout his treatment and to the end of his life. And that comes with a more anxious component where after he died, for me personally, it felt like this eerie quiet and stillness of there isn't a medical portal to check. There isn't it a there isn't a chemo company to call to deliver his medication. There isn't the appointment with the neurooncologist. We're not checking in on his medications. It's just kind of this this quiet, but it's also so heavy that it's almost like you feel like for me, it felt like someone pulled the rug rug from underneath me, and I just, I was, I was falling. And the person who's usually there to catch me, I no longer have. And that's what I think makes grief so complicated, is because I say that it's a neurobiological process. It is not simply emotional. Our brain is rewiring and it's adapting to this, this lot, this very remarkable loss that can take people a quite a long time to process.

SPEAKER_03 6:58

And that's such a good point of your brain is rewiring. Because I've never really thought of it that way because it's so emotions driven, or that's what we feel is happening, is such strong emotions. So, can you talk a little bit more about that and what's happening?

SPEAKER_00 7:11

Yeah. And this is what I think it's so important that, especially for me if I'm meeting with a patient, is giving them gently this education about grief and grieving. Um, because what I hear is a lot of shame or blaming of why can't I think clearly? Why am I not functioning the way I was functioning before the person died? Why do I feel a sense of like I can't concentrate? And these are very much symptoms of grief. So, yes, there is the emotional experience. And then we've also seen from tremendous research studies when we look at the brains of grievers, we see things, for example, heightened activity in the amygdala, which we know is our stress and fear response. We see lower activation in the prefrontal cortex, which is more our logic, our problem solving, our executive functioning. We see symptoms like brain fog, like insomnia. We see more stress hormones. So, all of those together, coupled with the emotions of sadness and sorrow, I mean, that that's truly when we're looking at someone holistically, what the experience of grief is. And the last thing that I will say about grief is sometimes people will ask me, am I experiencing grief or am I experiencing depression? And you can have both. You can also have one and you can have the other. I will say that when we experience grief, it's typically described as a yearning or a searching for the person or the loved one. And to me, that is more of that neurobiological process because our brain has this map of the world and of our loved ones. And when that map changes, we have to change. Our brain has to adapt, it has to rewire. Where in depression, it's a more global, all-encompassing experience and constellation of symptoms.

SPEAKER_03 9:04

Yeah, that makes a ton of sense. So, in the rewiring, what coping mechanisms or processes do you recommend to be able to work through that? Because it seems like something that you aren't ever necessarily over, but you can live with and become functioning again. So, what kind of pathways can people do or practice or use to get there?

SPEAKER_00 9:28

Sure. So there's grief counseling, which is really education about the process of grief because grief is not a disorder. Grief is a natural experience that all of us will go through at some point. And it's the brain and the body's way of trying to naturally process and heal and move through along with the grief. So that's more giving the education and grief counseling. And then sometimes you may hear things like prolonged grief disorder or complex or complicated grief. And that's when there may be elements of trauma, elements of depression, elements of anxiety, and things like grief psychotherapy can be immensely helpful. Um, in what I've seen in the literature and research, is in terms of targeting grief, there isn't a tremendous amount of medications that treat grief because it's a natural experience that we go through and it's a process. So I'm a big proponent of psychotherapy, and there are a lot of studies that things like cognitive behavioral therapy can be immensely effective for helping someone work through grief. So when we think about cognitive behavioral therapy, it's really this foundation that our thoughts, our feelings, and our behaviors are all connected. So if we want to shift how we're be how we're behaving or how we're responding, we really need to get at what's the emotion that's coming up for me and what thoughts are fueling that emotion. So how can I shift those to be more adaptable or more realistic?

SPEAKER_03 11:01

Interesting. So are you k trying to train your brain to think differently to make that happen? Or what's what's the process, or I guess what's actually happening with the therapy that someone would work through getting through that?

SPEAKER_00 11:15

Sure. So it can be targeting things like catastrophic thinking or black and white thinking, with which is what we call thinking traps, right? Um, I don't have anything in my life that's important anymore. When someone's acutely griefing, this is a very common thing to hear. And it's valid. And as a psychologist, I will validate that thought. I will sit in that feeling with them. And can we gently also bring in other elements of, I also have X, Y, and Z people in my life who love me and support me, who I want to show up for. Right. It doesn't dismiss that feeling and experience. It's how can I find balance in living with both? How do I have maybe some choice over my suffering?

SPEAKER_03 12:00

That reminds me, I'm reading a book right now called Rewire, which is all about rewiring your brain and thinking through, I'm not gonna do the book justice, but it's all talking about how your thoughts and then behaviors, like you're saying, are connected and will basically make a well-worn path in your brain. And so, I mean, there's so many applications, like just positive thinking versus negative thought patterns that you have. How do you identify the negative and make sure that 90% of your day is not in negative thought patterns and you're shifting it from I can't to I could if I worked on this or you know, whatever that that changes. So that just brings about so many, so many more questions I have too, then, because one thing you said was that, you know, grief and depression can exist together and be separate. And when we talk about mental health in general, one of the top ones that comes to mind for me is anxiety and how it just, I mean, it can pop up at all times. It can, especially as we get older as women. It's like, what is this anxiety that I never used to have before and now it's here? And so the anxiety, depression, like a lot of mental health things get bucketed into mental health. So I'm curious also just to hear your take on the anxiety piece of it and what that plays and what you've seen with other women as well.

SPEAKER_00 13:27

Yeah. And I love this conversation because I want to make the differentiation between we all have mental health, just like we all have physical health, right? We all have feelings and emotions and thoughts. That's a great thing. And having a hard moment does not mean you have a mental health disorder. I think that there's been a lot of misinformation misinformation or this push of what we call psycho-babble of that's a trauma response. That's narcissism, oh, that's depression, oh, that's anxiety, or we're trauma bonding. And I think that while I'm glad we're talking about mental health, I think we want to be really mindful of the words we use, right? Like someone being like, oh yeah, I'm really organized, I have OCD. Those are not the same by any means, right? Like, oh, they're grieving, they're depressed. That's not the same. So we all have mental health, we all experience, for the most part, sadness. We experience anxiety. In fact, we need anxiety to perform. If anything, when I work with younger kiddos, I say it could be a superpower. It's about sometimes befriending the anxiety. Oh, you showed up. Okay, here you are. You're applauding for me. Maybe you're cheering me on, you're helping me perform. And we also know, though, that when anxiety gets too high, we hit that point, though, that it's no longer helping us. It's kind of devastating our performance. So we want to get in that sweet spot. So I will say for a lot of people who do experience anxiety, is thinking of ways of okay, this is showing up for me. What is this trying to tell me? Do I believe it? Is there data behind it? Is it a logical thought or is it just a thought? You know, a big thing we talk about in the mental health world is thoughts are not facts. And the majority of thoughts are not true. We do not have to believe every thought that comes into our mind. In fact, like you said, neurons that fire together wire together. So we have control over the thoughts we choose to continuously tell ourselves and that fuel us. And we also have control over recognizing that this thought is is unhelpful. It's not benefiting me. It's not based in my reality or my values. So I'll allow it to pass. I'm not gonna fight with it. I'm not gonna shame myself for it. I'm gonna acknowledge it and move through it.

SPEAKER_03 15:48

So, what are your tips if you know it's not a fact? That's a hundred percent where I often live. And I think what I've tried to explain to people before, like the feeling that I've had of anxiety, I know a lot of bouts of anxiety that I've had can be, in hindsight now, pushed back to either a health thing I was going through, um, or there actually was facts behind it. But I think in the moment, just struggling to explain it when you don't know where it's coming from because I'm not stressed. You know, immediately people are like, oh, well, you have kids, you're running around, you have all these things that you're doing. And I'm like, I mean, kind of, but not really. So, like, where is this anxiety coming from? Because I shouldn't be anxious. Like, I I feel like I have a low level of stress in my life, but a high level of anxiety at times. So I'm curious, what do you do in those instances or what tips do you have for people when it's not fact-based? And like, do you squish it like a whack-a-mole? Like, what do you do? Like, what's how do you work through that one?

SPEAKER_00 16:52

I will say, especially because you brought up when we're we're also talking about women and also people in general. I always say before you go to see a psychologist, go see your primary care doctor, take your kid to see their pediatrician, have their blood work done, have whatever tests they seem appropriate for the symptoms you're mentioning. Just because we also want to ensure that we're coming at this from all angles, right? Is there something additional going on that a physician can help address? And how then a physician can speak to a psychologist so we can work together as a team? So I would say that um there's something I love. It's part of what we call ACT acceptance and commitment therapy. It is a third wave of CBT. And sometimes this is helpful for people where they're constantly like, oh, this is a cognitive distortion, this is a thinking trap. Like, and some people they they kind of get tired of putting their thoughts through court where it's more of this let it go, let it be. How do I live in line with my values? So okay, I acknowledge the thought instead of saying I'm anxious, I'm an anxious person, right? We want to engage in what we call cognitive diffusion. We want to separate ourselves from the thought. You are not the thought of anxiety, you are a person who is experiencing an anxious thought. So believe me or not, there are studies that show that when we shift our language from I'm anxious to I'm feeling anxious because there's something inside of me that feels unsettled, or I'm feeling anxious because my kid came home from school and I think that they might be sick. That's different than I'm anxious, I'm an anxious person. I'm always a stressed-out person. And that separation from the thought has actually shown to, like I said earlier, decrease activity in our amygdala, which is our stress response in our brain, and increase activity in our prefrontal cortex, which is our logic rational thinking brain. We have to practice this over time. It's not just a one-moment magic wand, oh, the anxiety is gone. In fact, you very well you very well likely may still be feeling anxious. The idea is over time, you're not responding as much to that anxious thought. It's more of I'm choosing to recognize this thought is coming. Perhaps I know why, perhaps I don't know why. Is it some is it something I can engage in problem solving, or is it just a feeling? And can I allow it to pass and then go on with my life and what I see as valuable?

SPEAKER_03 19:30

That's good. So for you, do you find yourself telling yourself this in situations? Is there a tool that you use when you're going through hard things, or you find yourself falling back on the most?

SPEAKER_00 19:44

I think that it's really common to have the experience that you're mentioning of sometimes I feel this unsettledness of something is off or something is wrong. And that that's something I've experienced a lot since my dad died. And I I think that was me being in overdrive for so many months and my body now being used to that. I've wired my system for that. Um, I also think people who are very high functioning and high performing, when we actually sit with ourselves, we feel like something is wrong. You know, for me in my grief, I'm constantly doing and doing and intellectualizing, which is not the healthiest thing. And then when there's no one around me and I'm alone and it's just silence, that's when I start emotionally processing. And that's when I'll start having things like crying for a few minutes, like expressing the motion, like letting out the sighs. And what I tell myself in that moment is you're grieving because your dad died, and it's unfair. And you didn't want to I didn't want to experience this this early in my life. I didn't want my dad to experience this. I didn't want my mom, my brother, my family to experience this, and yet I didn't have control over his illness. So I can be sad. Grieving, it's also me continuing to love him the way I've known to love him. So I find beauty in that. I find beauty in allowing ourselves to feel our feelings and to talk about them.

SPEAKER_03 21:19

I love that. And I love what you said about sitting with the emotion. It is hard to do when we're busy and there's a ton of stuff going on, and oftentimes we make ourselves more busy to fill that time, like you were saying, when really a lot of research is coming out on the power of nature, of going outside. Um, I think there's studies done that will look at someone who lives in a city, and you when you go outside, there's a lot going on. So your body naturally is scanning for you know, danger, you know, checking things out. Like there's a lot coming in that we're soaking in and observing where if we go out in nature. And take a walk on a trail. Yes, we're still looking around. We want to make sure there's no mountain lion coming at us, but just the amount that's infiltrating us goes way down, and we're able to have space to relax and actually process things. Where that saying, take a walk to clear your head can come from. So I think there's also just creating those pockets of space, whether it's to go on a walk or just stop the doom scrolling. It's just so needed to be able to deal with things correctly and not just have them bottle up and pile up either.

SPEAKER_00 22:39

You bring up a beautiful segue that I wanted to make sure I got into. I focused a lot on the cognitive, really the thinking piece of both mental health and of therapy. And you bring in this huge one, which as psychologists, we like to use the fancy term, which is really like movement and doing things and not engaging in avoidance, is behavioral activation. We see for many mental health disorders, and also just for improving mental health, behavioral activation is extremely important. So engaging in activities, like you said, there are a tremendous amount of studies that have shown things like um SSRIs, which is you know a form of an antidepressant, have shown to be equally as effective as people who are enrolled in research studies where they're they are engaging in aerobic activity regularly. So, yes, exercise, walking. And I always say, if I would I wish I could prescribe things like walking, exercising, whatever the person's body is able to do. And if you can do it outside in greenery, that is to me a huge bonus because greenery has also been shown to have great effects on our minds in terms of creativity, in terms of calmness, in terms of relaxation. It's a huge bonus.

SPEAKER_03 23:54

Yes. I think even in that same rewire book, they were giving an example of we need work every day in a building, and then we go to yoga in a building and we think we're being healthy, and then we have, you know, something good to eat for dinner in our house, and all of a sudden we're not outside around greenery at all. So there's almost the mark of being proud of how many minutes you can spend outside with greenery, as like that should be something that we track. You know, we track our steps, but like it's good to get your steps in no matter what, but like try to get real sun, try to get outside and be with greenery as well.

SPEAKER_00 24:36

Right. And like you're saying, these are all things that are maintenance for mental health, right? And also if you do have a mental health disorder, these are also great things in addition to seeking out psychotherapy, in addition to seeking out a psychiatric evaluation.

SPEAKER_03 24:53

Yeah. And that's, I mean, it is very much the foundation. So I'm curious what there's other things that you see in general with mental health, where people are just not doing the building blocks maybe correctly. And what would those building blocks be that you would recommend for everyone?

SPEAKER_00 25:09

Yeah. Major things. And I also recognize that we live in a world where there are people with immense privilege and there are people who are really making ends meet. And I recognize that for some people, like you said, going to yoga class, right? If I'm speaking to a family of lower SES where families are where parents are constantly working and they barely have a minute to sleep, that's not something I'm gonna bring up, right? So I also want to tailor to who I'm working with, what's realistic for a person in a family. In terms of mental health, there are absolute foundations. One that I think is very overlooked outside of nutrition and physical activity, sleep. Sleep, hygiene, the way we take care of our bodies in terms of our rest is so important in terms of our brains, our mood, everything within our system.

SPEAKER_03 26:02

Yeah, that's a huge one. I am like, die hard. Don't, don't bug me in between 9 and 5 a.m., I don't even sleep with a phone in my room. Um, I'm religious about it. And I think that's one of those things where like the wild amount of studies, and I don't know if you have any on the top of your head, that just shows the impact on physical mental health, like all of it is so crazy.

SPEAKER_00 26:27

Yeah. Yeah. And a lot, you know, a lot of the mental health disorders that we diagnose, one of the symptoms that we include is significant changes in someone's sleep, oversleeping, undersleeping. Um, and we know that our brains, they need rest. We also know, especially when I work with younger kiddos, right, at every different developmental stage, there's different hours that are recommended for sleep. And I think that part of when we talk about sleep hygiene is we also talk about, well, what are we doing during the day to help us with sleep? Because a lot of people will tell me, um, yeah, I don't know. I just I can't, I can't sleep at night. And I'm like, well, tell me what you do during the day, right? If you're moving your body, if you're, you know, drinking water, if you're eating a relatively nutritious diet, if you're engaging in things that you like. Right. I'm not saying then you are gonna sleep, well, I'm just making sure that are we doing those things during the day, are we reducing the amount of screen time, like you said, the amount of doom scrolling? Are we engaging in things that help with our sleep wake cycle? Because it's really a cycle. We have to think about what we're doing when we're awake during the day in conjunction with what we're doing at night before we go to sleep.

SPEAKER_03 27:43

Yeah, where, you know, for example, getting sunlight in the first 20 minutes that you wake up to be able to trigger you are now awake. Like, let's get going, and then you can keep the cycle in lock.

SPEAKER_00 27:54

Right. Or for example, uh, having multiple cocktails before you're about to go to sleep, that that can be very problematic, right? We have to figure out how we help your how you help yourself while you're awake to also facilitate sleep. Now, I say that and people can still stru struggle with sleep issues. So then we want to do a more direct treatment approach. But I also want us to think about what are people doing while they're awake that is either facilitating good sleep or it's facilitating poor sleep.

SPEAKER_03 28:26

Yeah. And when you think about direct treatment, what is usually the first go-to for that? In that is it just actual medication or like where do you guys go when all the lifestyle changes aren't working?

SPEAKER_00 28:39

Yeah. So for me as a psychologist, I don't we don't prescribe any medications. That would be more of a psychiatrist or a primary care doctor. What I have done in my practice is things like CBT for insomnia. So there's actually specific protocols and manuals that really focus on how are we targeting what you are doing during the day and how you're preparing yourself for sleep. And, you know, like a little thing to think about, which people are surprised, is that instead of sitting and tossing in bed all night, the recommendation is to actually get up out of the bed, right? Because we're associating the bed with sleep. But when we're sitting there, we started to create a new association where the bed is I'm uncomfortable, I'm, I don't want to be here, I can't sleep. Where the recommendation is then remove yourself from the bed, engage in whatever we talk about, and then return to the bed.

SPEAKER_03 29:29

Interesting. So, like go read a book, because do you want to be stimulating your mind, or do they just tell you to remove yourself and try to relax and then come back in?

SPEAKER_00 29:38

So it's really person-dependent. Something like reading, for example, I would say is a low stimulation activity. Something like playing a video game or going on a screen is definitely a high stimulation activity that we want to avoid. Um, a big thing when I I think it's great for adults, but I do it a lot with kids, is what is their sleep bedtime routine?

SPEAKER_02 29:58

Right?

SPEAKER_00 29:58

Are we turning off screens an hour to two hours before bedtime? Is bedtime consistent? Is wake time consistent? Is the room dark, cool, and comfortable? Are there things in the room that are impacting sleep, right? Um, you know, some people are surprised to hear some of the studies that talk about the temperature, right? That we said our bodies actually need a cooler temperature for a lot of people, perhaps not for some folks. They it needs a cooler temperature when we're sleeping, right? We need less light coming in. And then, like you said, our wake cycle, right? Are we getting light in the morning to stimulate ourselves while we're awake to then shift to nighttime?

SPEAKER_03 30:40

I think I turn we turn our temperature down to 67 when we sleep and then try to keep it at 69 or 70, depending. I'm curious. What do you sleep at? Do you have a doubt?

SPEAKER_00 30:51

I 68, 67. And what I've recently read is that 67 is is pretty typical of what's recommended.

SPEAKER_03 30:58

Yeah. Yeah. Cause I'm also just curious, knowing everything you know, what else in your life is a non-negotiable? What do you do on the physical, emotional, mental front to just stay healthy on all three of those buckets?

SPEAKER_00 31:14

Yeah, this is one that I don't know if people will be surprised to hear, and I don't know if it gets enough credit, is social support. So having people that we can turn to and go to with all of our experiences, when we're experiencing joy, when we're experiencing grief, when we're experiencing anxiety or sadness, having people in our lives that we can go to, whether that's a spouse, whether that's a parent, whether that's a best friend, whether that's a coworker. Sharing that is so powerful. We even think about it when we talk about people who are experiencing a mental health crisis. One of the big things I create in what's called a safety plan is who can you go to for support? Who can you call? And a lot of people have told me that making that call made the difference in terms of what I wanted to do next. So I think social support doesn't get enough credit.

SPEAKER_03 32:09

Yeah, and that's one of those hard ones as you get older too, and life is crazy. You have kids, you often lose time to make room for relationships and connections, or lose friendships or lose friends, and then making new ones is so daunting.

SPEAKER_00 32:26

Yes, and I will say as someone who I now live in a city that I did not grow up in, and I have a great group of best friends back home, it it was quite a challenge and an adjustment. Um, I will say, you know, I'm bringing back the element of grief, is that for example, my experience is that when you go through losing someone like a parent, the people that you thought would show up may not show up. And the people that you never expected to show up may show up. And again, you don't have control over that. But what I would say is being on the other side, if you can show up for someone, whether they're grieving or they're going through something difficult, if you can and you have the capacity, just show up. You know, a lot of things are like, oh, let me know if you need anything. No one's gonna ask.

SPEAKER_03 33:19

Yeah.

SPEAKER_00 33:20

Just show up, check in, even messages like, hey, you don't need to respond to this. I just want you to know that I'm thinking about you and I'm gonna plan to bring this by. Right? Showing up is so important. I say that also to put a little bit the idea in the people's minds of those who are seeing people in their lives who are struggling is just show up. It doesn't have to be for a long period of time. It can be brief moments, but it really makes a difference when people show up for each other.

SPEAKER_03 33:50

That's so good. I think especially people almost avoid it because you don't know, the only thing you're thinking of is I'm sorry. And you're like, saying I'm sorry is not helping. Accurate. But there are other things you can do to show up, even if it's a quick note or just doing it. That's so good.

SPEAKER_00 34:09

Yeah. And I will say things that I think are unhelpful to tell someone when they're grieving, and I don't want to say this is universal because everyone grieves differently, is saying things like, oh, they're in a better place, or um, I get it, or okay, you're gonna be fine. Those are really unhelpful. Grief needs to be witnessed, it needs to be experienced. So sit with the person, let them share what they want to share, ask about the person. I think another thing that I've heard um from friends and people is that usually when someone passes, like it's like people don't want to talk about that person and they don't bring them up. And my experience has been like, I want to talk about my dad. I want to talk about this incredible person. And if I cry, it's it's not because I'm angry that someone asked, it's because it's this emotional burst that's even a little bit of relief and joy of how lucky was I for 35 years to experience this person. And I want to share his story and I want to talk about him. And I appreciate when people say his name. I appreciate when people talk about him.

SPEAKER_03 35:20

And especially if someone had a shared experience with him and remembers something or can reflect on it with you and have that experience as well. So I appreciate those tips because I do think a lot of people struggle with what to say, how to show up, and those are all really tangible and helpful.

SPEAKER_00 35:38

Yeah, and it may be even helpful if I do the flip, which is things to say to someone who is experiencing grief is I'm here with you, I'm gonna stay with you.

SPEAKER_01 35:48

I'll be back tomorrow. Like, tell me what you're feeling. I'm here. Yeah, that sounds terrible.

SPEAKER_00 36:00

That's basic human validation that all of us need.

SPEAKER_03 36:04

Yes, I love that. And one huge piece of your work is working with kids with mental health. And so I do want to touch base on that because I actually just read the book, The Anxious Generation, which OMG, as a parents or a mom, I'm just my mind is blown in that anyone who hasn't read the book, there's so many good concepts in there that it's introducing. But at the crux, it's talking about how the introduction of an iPhone in like the 2010s correlated with a decline in mental health with for kids because of what they're seeing is a change from play-based childhood to a phone-based childhood. So I'm curious to hear what you've observed in some of your patients and just you know, new kids these days and the battle with mental health that we're seeing tick up over the years.

SPEAKER_00 37:03

Yeah, this is such a common question, and I don't like saying it depends because there's research that indicates certain things and research that can indicate other things. So I try to wear both hats. So I would say social media and the internet and people connecting through online for people who don't have support, oftentimes kids who are marginalized or who are discriminated or who are part of, example, for example, the LGBTQ community, they can sometimes actually find people and connect and feel supported and have resources. So that can be a very positive thing. Social media in general has shown to have very addictive components to it, especially for the developing brain. We talk about ages 10 to 12 is a very vulnerable period in a child's brain where they have heightened sensitivity to social recognition, um, social likeness. So things like likes and hearts and comments on posts, they're very sensitive to those things. So I, as a person, I would say I am not too fond of social media platforms for kiddos really under the age of 15. And when they do get those platforms for them to be private, for parents to have very open, honest discussions about social media, about things they will encounter, what to do if they encounter certain things, and also having parental controls over those. I don't say that in a hovering way, I say it in a we want our kids to be informed and we want there to be limits, right? So also, I think on the parental controls, for example, you can turn off those apps, right? There's a limit to the amount of time because it is addictive. And there have been studies that have shown, you know, longer social media time, for example, up to three hours, um, with an addictive nature is shown to increase things like depression, suicidal thoughts, and perpetuate eating disorders among teens. So it's really, I think, as a parent talking about these things and educating your kid and having the ability to set limits because as parents, it is it is our job to provide limits for kiddos because their brains are developing, not in a way that's punitive, but even explaining it to them.

SPEAKER_03 39:29

Yeah. And that was the piece that hit me really hard too was thinking about how impressionable they are when their brains are growing and developing and creating those pathways for the first time, and how addictive a phone can be, even to me, still. I don't even, you know, would consider myself like truly addicted, but still how many times we check a phone every day just out of habit, like, oh, let me check email real quick. I don't need to check email. Why am I doing that? Like, if I'm doing that, then holy cow, what can this thing do to kids? Is just like that scary realization and thought and kind of the concept of the book of that parents are overprotective in the real world, but underprotecting your kids online. Um, so just delaying that introduction so they can have a play-based childhood and have real world experiences, the relationships you're talking about, building those social connections and just being a kid and all the socialization and real world experience you need with risk and freedom because you're not inside on devices anymore or as much.

SPEAKER_00 40:39

Yeah, and and teaching kids how to pace and do things with balance, right? Like you can do something for 30 minutes on a tablet and then go spend time outside, go spend time with your siblings, um, help set the table for dinner. Um, I think that what you mentioned is important is that we have this concept of stranger danger. And the reality is that it's not really stranger danger anymore, right? The majority of kids who, for example, experience things like sexual abuse, it's typically someone who is known, right? So it's not gonna be the stranger hiding in the playground when your kid goes on the monkey bars, it's gonna be someone online who is masking as someone else who is trying to get in based on what they like or what they're looking at online. So we need to help kids prepare with this education.

SPEAKER_03 41:29

Yeah. And is there anything else on the mental health front with kids that you see or deal with a ton and help parents work through to um either tackle things or keep kids as mentally healthy as they can as they're growing up to adults?

SPEAKER_00 41:46

I think I one thing that you mentioned about screens that I want to go back to about this is coping skills. So what's happened with all of us is right, like, you know, this is I'm I'm coping because I'm stressed, right? I'm I'm just I'm on my phone. So it's become a coping skill. And what I tell people is I want you to develop coping skills that if you had nothing, for example, no device in the room, how would you cope? How would you manage? Right. Because that can't just be our default, is going on the phone is our only coping skill. So for kids, I think it's important for them to have coping skills at an early age. Um, a lot of things I talk about with parents are listen, bring up conversations, validate feelings, normalize feelings, right? Because when we don't normalize them, we sh we we often induce a lot of shame on kiddos, right? I say kiddos are really curious. So when they come to you about something, it's because they're genuinely curious. So as parents, it is our role to talk about them in a way that they can understand. So listen, ask questions, validate. Sometimes it's even like if you don't want to talk right now, that's okay. I'm gonna stay with you. And perhaps when you're ready, you want to talk. Again, I I agree that parents are not best friends. Parents also have the responsibility to set limits and to protect their kids, for example, from excessive screen time from situations out in the world that are harmful.

SPEAKER_03 43:14

Yes. Oh, that's so good. Well, I know we're coming up on time. Is there anything that you wish we would have jumped into or talked about that we didn't?

SPEAKER_00 43:25

Um the one thing I'm going way back to the beginning is when we talked about grief and we talked about different forms of therapy and treatment to help someone who's going through grief, is um, I hope that the message wasn't just these are negative thoughts or they're extreme thoughts, right? That's that's not the intention. The intention is how do we help someone process and adjust to living life now as someone who is grieving? And the other big piece of that therapy is meaning making and legacy building, which it might be a beautiful way to end. Is for me, for example, sharing my dad's story, talking about him, finding the qualities that he has that I so badly want to emulate because I absolutely adored this person to me is legacy building and it's meaning making that wow, my dad did all these things for me, and that there's so much meaning in that. So, how can I continue to make meaning with him in a different dimension, in a different realm that I may not be able to hear his voice or talk to him, and I still feel his presence, right? And I'm also very big, at least I am in my family, is about signs, right? And this is something people with grief talk about a lot is signs that the person is near, right? Like for for my family, my dad, we have this funny thing that he's a little ladybug, right? He shows up as a ladybug. So when I find a ladybug randomly like crawling on me or coming near me, I feel it as a sign. And whether that's true or not, what's important is that it brings me comfort. So for anyone out there who is grieving, if it's a butterfly, if it's a cardinal, if it's a ladybug, if it's the light glitching, if that feels like a signal, enjoy that. Allow that to be part of your process with grief and allow that to feel like a sign because I truly do believe that people continue to be with us in spirit and in our minds and the way that we choose to have them.

SPEAKER_03 45:32

And in our behavior and meaning making, like you're talking about. And I know when you initially reached out um about the podcast, that was a big piece of it, which we then got to come and hear all about your story and so many more tips about mental health. So I just so appreciate you coming on and sharing more with our listeners.

SPEAKER_00 45:53

Yeah, I'm so glad we had this conversation.

SPEAKER_03 45:56

And if people want to find you anywhere, where can they find Dr. Tosh?

SPEAKER_00 46:00

Yes, you can find me at drtosh.com. You can also send me an email at info at drtosh.com.

SPEAKER_03 46:08

Thanks for listening to another episode of Find Your Fuel. If you enjoyed the show and want to support us, please leave a comment or review. And before we go, I have to give you the obligatory medical and legal disclaimer. This podcast is for informational and educational purposes only. The advice and recommendations we discuss are not intended as medical advice and do not replace the treatment or care of a physician or any other primary health care provider. Using the information shared today does not create a doctor-patient relationship and it should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional before making changes to your diet, exercise routine, or medications. The use of any information provided is solely at your own risk. So, in a nutshell, let's be smart and remember these stories and conversations are for educational purposes only. Help other women find the fuel to live their best lives. We'll see you in the next episode.