A discussion on mental health during the holidays [PODCAST]

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In this episode, we welcome Jennifer Shaer, a pediatrician, to discuss the issue of physician suicide rates and how the holidays can impact mental health. Despite being one of the happiest countries in the world, Scandinavian countries like Finland and Denmark have some of the highest suicide rates, higher than the rest of Europe and the U.S.

Jennifer shares her insights on why it can be harder to be sad when everyone around you seems happy and why giving yourself a reality check is important. She also offers tips on opening up about your feelings and being honest with yourself and someone you trust.

For those truly happy during the holiday season, Jennifer shares ways to support others and offer a safe space for them to unload. Join us for a discussion on the impact of holidays on mental health and what we can do to support ourselves and each other during this time.

Jennifer Shaer is a pediatrician and chief wellness officer, Allied Physicians Group, and a certified executive and life coach. She is founder, Shaer Coaching, and can be reached on Facebook.

She shares her story and discusses her KevinMD article, “The holidays can open up a range of emotions.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Rate and review at KevinMD.com/rate. Subscribe at KevinMD.com/podcast. Today on the show, we have Jennifer Shaer. She’s a pediatrician and chief wellness officer at the Allied Physicians Group. We’re going to talk about her KevinMD article, “The holidays can open up a range of emotions.” Jennifer, welcome to the show.

Jennifer Shaer: Thanks so much for having me, Kevin.

Kevin Pho: So we’ll get into your article in a little bit, but first off, briefly share your story and journey to where you are today.

Jennifer Shaer: So I am a pediatrician. I’ve been a pediatrician for 20-plus years. When I think about my journey of how I got from there to here, so to speak, it’s funny, because I think about the fact that I didn’t necessarily ever want to be a doctor. I was one of those kids, a science and math kid, and becoming a doctor was sort of the path of least resistance. Actually, my mother was always kind of pressuring me, “Be a doctor, be a doctor,” and so that certainly made me not want to be a doctor. But I went to school and I studied biology, and what the heck else do you do with a biology degree when there are no good ideas for careers other than being a doctor? So I went ahead and became a doctor, and I have no regrets. I love what I do. I chose pediatrics.

After becoming a pediatrician, I had a little bit of a meandering course at the beginning and ultimately decided to go into outpatient private practice. I had an amazing opportunity in that my father-in-law was a retiring pediatrician and was begging me to take over his practice. So I ultimately called a friend from residency and said, “Let’s do this,” and we took over his practice and got going. We really, really felt connected to the community but quickly realized that there’s so much more to practicing medicine. So we rolled our practice into Allied Physicians Group, which is like a group without walls, in a sense. It gave us the backdrop, the support of the IT and all the infrastructure that we needed, so that on the front end we could be the general pediatricians in the local community, and on the back end have the support of a big company.

From there, I got very active in the company. I became part of the board of directors, became the chief medical officer, and then ultimately this chief wellness officer. So now I see patients part time, I’m the chief wellness officer part time, and I’m also a coach for mid-career pediatricians who are burned out and looking to either save their career or create a new one. And that’s where I am so far.

Kevin Pho: So tell us more about being a chief wellness officer, a little bit more about that role.

Jennifer Shaer: Yeah, so the role of the chief wellness officer is to really prioritize, to make wellness as important to the company culture as quality and all the traditional things that health care systems are focused on, because physician well-being is really the secret sauce to the success of a medical group. That means having an executive-level person focused on that, not only supporting the well-being of the doctors but also being the voice when a policy is coming up: What can we do to make things easier? Where can we make things better? And it’s really amazing to have a company that’s supportive of that role. Not too many companies do that.

Kevin Pho: So one of the things that you said really resonated: One of the main missions of your job as a chief wellness officer is to make clinician wellness as important as some of the other measures that the company may be interested in. Can you give us an example, share a story or a case study of how exactly you’ve done that within your company?

Jennifer Shaer: Sure. So this is a brand-new position, so I’m very excited. It’s January 1st. But right off the bat, my first project has been to take the pain point. What’s my personal pain point? I still see patients, so I’m deep in it, and for me it’s charting, it’s all of the charting. So we’re in the midst of a scribe pilot where we’re testing out different scribe companies, and already, one of my clinicians who started it said, “I feel liberated.” It’s just that type of thing, where the burden of charting is really just making the doctors feel so.

Kevin Pho: All right, so let’s talk about your KevinMD article that was written in December. It’s titled “The holidays can open up a range of emotions.” Now, how did this article come together?

Jennifer Shaer: A couple of things were happening at the time. For starters, the amount of anxiety and depression that I see in my patients, in and of itself, is staggering. Pediatrics has moved from sore throats and earaches over to anxiety, depression, and ADHD. It’s really completely changed. And there’s just so much talk about burnout in physicians. I think right around the time I wrote this article, I saw something about National Physician Suicide Awareness Day, and I didn’t even know that existed. I think it’s sort of horrifying that we have to have a day like that. But at the same time, my sister actually told me about something tragic: One of her friends lost his daughter, who was a pediatric resident, to suicide. So those two things together, along with, I don’t know exactly where I saw the story about the happiest countries having the highest suicide rates, those three things together, and then the article just sort of wrote itself.

Kevin Pho: Sure. So I think the World Happiness Report was mentioned, right? A connection between happiness and suicide rates in Scandinavian countries, right? The sort of inverse relationship: If you’re surrounded by happy people and you don’t feel so happy, you feel even worse about yourself. So talk about that. Why is it harder to be sad when everyone around you is happy, and then how does that affect mental health?

Jennifer Shaer: Yeah, so when you have this dissonance between what you’re feeling and what you think you should be feeling, it almost adds suffering to the pain. So your dog dies, you’re going to feel sad. It’s normal to feel sad; that makes sense. But if you’re at a holiday party and everybody’s happy and you’re feeling down, it’s more than just the feelings of being down. It’s that you should be happy, and that just adds, like I said, that second layer of suffering.

Kevin Pho: How can you stop comparing yourself, breaking away from that mindset, especially during the holidays? Because there are so many holiday parties, and everyone in general is happy. What kind of recommendations can you give to break away from that mindset of comparing?

Jennifer Shaer: Yeah, so first I’d like to point out that it’s normal to compare. We come from this evolutionary history of needing to fit in and be part of the clan and wanting to be liked, and so it’s our human nature to compare and want to be normal. So at least you can give yourself a little bit of a break and not judge yourself so much for feeling that way. And there are other things. You’re making connections with other people, and feeling a connection can help you a little bit. And also realizing that everybody, I think I made a comment in the article about how it’s the Facebook world, where everybody’s life seems so much better than it necessarily is. Everybody maybe seems happy, but maybe they’re not quite as happy as it seems.

Kevin Pho: Sure. Now talk about vulnerability. Sometimes it’s very difficult to open up about these feelings, especially during the holidays. So how can one go about doing that?

Jennifer Shaer: For sure, and I think you hit on something huge, which is emotions and vulnerability in general. It is so painfully scary to feel your emotions, but unless you’re going to sit quietly in the cave and stay safe, in order to do anything in life, there has to be discomfort. It’s almost like, what do they say? I don’t know who said this, but discomfort is like the currency of growth. You have to go through discomfort, like the caterpillar becoming the butterfly, right? I’m sure that’s not a very comfortable process. So being vulnerable, letting somebody in and letting them know how you feel, might be painful, but on the other end of it is the delayed gratification of where you’re going to get.

Kevin Pho: So I like that: Discomfort is the catalyst of growth. Is that something you’ve heard, or did you come up with that yourself?

Jennifer Shaer: No, I definitely heard that somewhere. I don’t know exactly where.

Kevin Pho: Now, as one strives to be vulnerable, or to be comfortable with vulnerability, especially during the holidays, talk about the role of support systems, family, friends, or even someone professional.

Jennifer Shaer: Right. So I always want to point out, just for a second, that there’s a normalcy to the ups and downs of emotions. But with the serious, serious depression, when you really get stuck and there are no ups and downs, it’s just down and more down, then you have to reach out for a lifeline. And I always really want the people who are feeling good to have a little bit of an antenna, to be on the lookout for people in their lives who might be feeling a little bit down, because it’s harder for the person who is in that weakened state to reach out. So those who are feeling good can pull them up. But yeah, when you’re feeling down, just send a text to somebody, or just force yourself to go out and make a connection. Humans need human connection, and during COVID, we all lost it.

Kevin Pho: How about seeking behavioral health help? Sometimes that’s very difficult; there’s not a lot of access to mental health specialists. So during times when everyone around you is happy, especially during the holidays, talk about potentially reaching out for behavioral health help and professional help, especially when access is so limited.

Jennifer Shaer: Yeah, there are lots of resources if you’re just willing. There’s the new, was it 988, the new support line. There are all sorts of text lines and emergency-type resources. What’s a little bit more challenging is finding consistent therapy from somebody. But honestly, it’s mostly challenging for people who don’t have money. If you have money, you can pretty much find what you need. It’s going through insurance, and this is the challenge for our patients. If you have Medicaid, it’s very, very challenging to get good mental health support, but when you have private insurance or you have the means, you can pretty much find it. And there are all sorts of platforms now that match therapists through insurance, third-party platforms and things. So I don’t know. And I think that it’s such a public health crisis that more money is going towards it, so I’m hopeful that there’ll be more access for people.

Kevin Pho: So what are some red flags that people should look out for that may necessitate them to seek behavioral health help, medications? What are some red flags that they should look out for in order to take those next steps?

Jennifer Shaer: Yeah, if you’re thinking about yourself, again, I always have that mindset: Am I talking about myself and my colleagues, or my patients, right? But in general, it’s when your mood has gotten so low that you’re not able to meet your activities of daily living, so to speak, right? So you’re having trouble getting out of bed, or you’re not eating well, you’re not sleeping well, and you’re not feeling happy when you’re in happy situations. You have that incongruent sort of feeling. I thankfully don’t personally suffer from depression, so I don’t know exactly how it feels, but people have told me, I mean, I have plenty of anxiety, but no depression. With depression, they say they feel a physical heaviness.

Kevin Pho: So we’re talking to Jennifer Shaer. She’s a pediatrician and chief wellness officer of the Allied Physicians Group. Her KevinMD article, which we’re talking about today, is “The holidays can open up a range of emotions.” So, Jennifer, as one approaches the holidays and knows that they historically perhaps have felt negative feelings after comparing themselves with the people around them who may be happy, is there anything people can do to prepare themselves mentally as the holidays approach?

Jennifer Shaer: Yeah, I love that question, because as a pediatrician, I am all about prevention. For me, prevention is the secret sauce, the best thing. And I wish that I had learned back in med school that there is actually preventive care for your emotional well-being. We all talk about diet and exercise, but there are lots of things that you can do to build up your emotional strength. There’s mindfulness and meditation and resilience-building practices that you can do, so that once you are faced with a difficult situation, because bad things are going to happen, if you have that muscle built up, then you can get through it much, much easier. So I would say that’s kind of a long-game practice. And if I could scream that message out to the children and to everybody when they’re young, they will be much better able to handle things in general, because it’s really hard to manage it when you’re in the middle of it.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Jennifer Shaer: Probably my biggest take-home message would be that it’s about, first of all, having the intuition to check in with your feelings and know what you’re feeling, and to prioritize your emotional well-being as well. You know, it’s not always about trying to worry about the world around you, but looking inward.

Kevin Pho: Jennifer, thank you so much for sharing your time and insight, and thanks again for coming on the show.

Jennifer Shaer: Thanks for having me.

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