Why Self-Care is Job One

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Hello and welcome to The Way Forward. I'm Allison Rooney from Barron's, and today we are joined by our guest, Dr. Melissa Milanek. Melissa is a licensed clinical psychologist and associate professor at the Medical University of South Carolina. She specializes in stress, anxiety, and sleep disorders. Melissa, thank you so much for joining us today.

Thank you, Allison. It's great to be here.

Yeah, thank you. And Melissa, I want to dive right in. In the past 4 months, Everyone has been experiencing uncertainty, change, loss, disrupted routines, schedules, and I have no doubt that the advisors listening on the line have felt anxious for their teams, their clients, and themselves. From your perspective in the medical field, how severe is the impact of what's going on in this pandemic on mental health?

The impact is extreme, and very few, if any, remain completely unaffected. Much emerging research is looking into this, also anecdotes and reports from providers. There's a lot it's being put out there and sometimes just trying to determine what information to follow. But from some recent pandemic report that came out, UNC and Harvard Medical School was one that put out a report and a number of other places. What we're finding truly is that there are significant increases in anxiety, difficulty sleeping, a lot of worry about personal health, safety, and health of family and friends. A lot of individuals reporting much more sadness, feeling depressed, lonely, isolated, frustration about not knowing what's next, and plus a lot of this impact of being stuck behind a computer screen, kind of these extreme feelings of isolation, loneliness, and just also losing outlets to be able to relieve their stress, not being able to do the hobbies or the physical activities that used to bring them some relief.

I know your specialty is in sleep in particular, so I wanna start there. We know that sleep can really help to alleviate anxiety and help with stress in addition to helping our brain function and immune system. Can you go into further detail about what the exact benefits of sleep in particular are?

Well, the short answer is that sleep is important for everything. We know that sleep is critical for so many aspects of our physical and mental functioning, memory, attention, focus, concentration. It's important for before learning and after learning to be able to be fully able to collect information and process it and store it for long-term. We see that for quick decision-making and ability to respond to challenges and truly every aspect of optimal performance. Sleep deprivation can oftentimes be related to reduced recovery, impaired mood, people becoming very reactive and making poor decisions. We can even see the effects as something as much as the day after daylight savings with that loss of 1 hour. You see research showing increased car accidents, cardiac episodes, So we know that also we do age faster when we're not getting the sleep that we need. There is something true about that beauty rest, as well as other health concerns. And so we know also with what's top of mind right now with the pandemic and our immune system, it's important to note that when you're lacking the right amount of sleep, your immune system is significantly impacted. Our T cells that fight off viral pathogens from all these different aspects, we can see them inhibited by higher levels of stress hormones. Good news is that the impact of these stress hormones are naturally lower when you're sleeping. When you're sleeping and are better at attacking and destroying viruses. So that's also why getting rest and proper sleep can be the best thing to help you get better faster when you're not feeling your best.

It seems easier said than done in many ways. I mean, especially in the environment that we're living in, you know, how do you go about creating a normal sleep schedule, especially when your, you know, office is a part of your home, perhaps right near your bedroom?

Part of really getting yourself on a good schedule is developing a healthy sleep routine, and consistency is going to be a key part of that. So one of the first bits is keeping a consistent schedule 7 days a week. And I know that that's something that's difficult for a lot of individuals 'cause we think we work a lot during the week, we're not getting as much sleep, and we try to catch up on the weekends, but that's actually not as healthy for us. It's the same as you wouldn't follow a certain diet routine during the week and then eat all your snacks on the weekend to keep up that weight loss or that healthy eating. So the first piece with consistency is having the same sleep schedule, the same sleep window 7 days a week, having a wind-down routine, which could be including reducing light, not having your electronics so close to bedtime, really helping the body and the brain be preparing for sleep. And then part of that too is having your bed and be reserved for sleep, for that rest and relaxation. Right now, especially, A lot of people are working out of their bed or they're finding that that's that place to hide to get away from the stresses of the day. But then our brains get confused. Should we be awake right now? Should we be sleeping right now? It's the same reason that we should only be sleeping in our bed and not on the couch or in the comfy chair or other things as well.

Right. So your recommendation is that you spend as much time away from your bed as possible. Does visible sight of the bed have any effect or is it just literally sitting in the bed?

Normally, I would say that if you have enough space where you can be out of the bed and out of your bedroom throughout the course of the day to be able to be separate from that, a lot of this comes from, we think, from a classical conditioning association standpoint, where when you see your bed, you want your brain to think rest and relaxation. For a lot of people, when they're getting in bed, that's the first time that they're alone with their mind all day, and it's running and racing, and there's stresses. And so we want it to be that your brain sees the bed and the bedroom and that triggers it to start to relax. That's also where that wind-down routine can be very helpful, of whether it is doing some relaxation exercises, brushing your teeth, getting into your night clothes, and different things like that as well.

I have actually heard you speak before, and you give great tips as it relates to helping shut down your brain before you go to sleep. Can you give our listeners some of those tips? I know journaling is one of them, and any others you can share with us?

Of course, of course. So many times there's getting the mind ready and the physical body ready at the same time. And so we know that whenever we're doing certain relaxation exercises, such as a 4-count or a deep breathing exercise to slow our breathing rate down to what it would be when we're— the respiration rate of when we're sleeping, doing things such as progressive muscle relaxation, so systematically tightening and releasing the muscles head to toe in order. We hold a lot of tension in our body. We tend to breathe a lot faster whenever we have stress and anxiety. And so all of those changes of relieving the tension and our slowing down our breathing trigger our brain. But there's also that part where your body can be ready for bed, but your mind is still going. And we find that for a lot of individuals, most of my executives that I'm coaching and that I'm working with, when I give them this bit of advice, they look at me and tell me that I've lost my mind. And I say, suspend judgment and try it for a few days. And they find that it works. What it really is, is that our minds have so much that they're processing, and because we're go, go, go throughout the day, we're not always affording ourselves that time to process. Just as the papers stack up on your desk or you're in your inbox when you're on a million Zoom meetings, and now you have to find a time to file it away. So take a notepad and a pen, not electronics, not a laptop or other things, old school notepad and pen so we don't have the light coming off it, which also can affect our sleep. And on the right-hand side of the column, you wanna write your to-do for the next day. I have to go to the bank, I have to make this phone call, I need to pack this lunch. And then on the left-hand side, you wanna literally dump everything that's going through your mind on that sheet of paper, but forcing yourself. Most people I say, start with 5 minutes, set a timer, do not pick up that pencil and just write everything that's free-flowing through your mind. It actually isn't gonna cause you to worry more, which is what a lot of people's fear is, but instead it's gonna bring to the surface all of these unconscious worries that have been running around in your mind all day, and that when you crawl into bed with no other distractions, they pop back up. As you're doing that writing, you may problem solve through pieces, you'll probably feel exhausted when you're done, just like that cathartic kind of ugly cry or angry yell, but then you take that notepad, you put it on your nightstand and you get into bed. If your mind continues to be running, You get out of bed and you keep writing until it's empty, and then you get in bed. You're training your brain that it doesn't get to process in bed. The same thing when you wake up in the middle of the night, you want to also get up. If you have that amazing idea, don't turn on your laptop, don't turn on your phone, 'cause that light is gonna trigger to wake up your brain as well. Write it on that notepad, and then you can deal with it in the morning when you're fully awake, and it helps your body to stop waking you up as much.

That's great advice and many things I've written down for myself here. One question I have for you on sleep is, do you recommend a certain amount or hours of sleep? Or I've heard from others that one size doesn't fit all when it comes to sleep and different people have different needs and requirements. What's your opinion?

Well, you're exactly right. And science shows us that the gold standard of 8 hours is an average. But whenever we have an average, there are gonna be some that need more and some that need less. And so part of that is determining for yourself what your ideal sleep window is, what your body needs at this time in your life, because it also changes. We actually need less sleep the older that we get, which is unfortunate because we seem to be young and active and we need sleep and never have enough time. And then we finally earned that maturity and that retirement, we're waking up at 3:00 AM. But it is finding that balance. Also, your activity level will play a role, which we're seeing being affected for a lot of individuals as they have been stuck inside during the pandemic.

Right, right. So how does one determine how much sleep they need as an individual? Is there a skill or a test that you can do to find that out?

So there are different ways to get about it, but the ideal way to determine your sleep window, it's a little bit of trial and error. But what I do when I'm working with someone to determine this is the first thing we do is start with where you are you are right now in determining how much sleep in a 24-hour period cumulatively that you're getting. So, if we counted up, if you took an hour nap in the afternoon, and if you got in bed, not the time that you were awake and you were doing other things, but how much time you were actually sleeping. If you fell asleep for 2 hours, were awake, asleep. So, let's say for instance, for this individual, it was about 6 hours. Then what we would do is we would start with a 6-hour window for the first 7 days. And we would set a wake time that's gonna be consistent, again, 7 days a week. So if the earliest you have to get up, say, is 6:00 AM, 'cause you have an online workout class that you're doing, or when we used to have to commute or get kids ready for school. If 6:00 AM is your wake-up time, then we would work 6 hours back and set a window, which would be midnight to 6:00. And for some people, that feels really, really late. So we could do 11:00 to 5:00 instead, But we would set a window of 6 hours and do that for 7 days. That means if you're tired at 11:30, you still don't get into bed. Also, if you fall asleep at 4 in the morning, you still get out of bed at 6 AM and you do that for 7 days. So your body learns when it's going to get that sleep and we're consolidating it into one chunk of time, which is really important for us to get the appropriate amount of body repair and mind repair throughout the night. After those 7 days, if you're falling asleep within 10 to 15 minutes, you're sleeping straight through the night minus waking up if we need a bathroom break, and we're getting up but we're finding that we're still tired, then we slowly start adding to that window. We never change the wake-up time though, we change the bedtime. So instead of it being 12 to 6, then it would be 11:45 to 6, and we would do that for 7 days. You actually only add 15 minutes at a time Well, that may not seem like a lot of time. That's a huge change for your sleep scheduling. And so we would do 11:45 to 6:00. And then if we're still tired, then 11:30 to 6:00. And over time, we figure out that sweet spot where you're again, falling asleep within about 10 to 15 minutes, sleeping straight through the night, and then waking up and feeling rested and not feeling that fatigue throughout the rest of the day.

Now that we've covered sleep, I wanna talk about the rest of our day, 'cause there are plenty of other places that we might get anxieties. One thing I'm personally struggling from is the long hours of being behind a computer instead of in the office. And I know advisors feel the same. You know, you're on Zoom calls all day long. I have a question for you. Is that Zoom fatigue real and how can we alleviate that?

It is a very real phenomenon that we are hearing, that we are seeing. And in part it's because this is a new way we're being forced to focus more intently on conversations. In different ways, but at the same time, we're being confronted with so many distractions. If we're honest, we've all done it. You're on a call and you're thinking you're gonna be productive, but the popup comes of some news update and you're getting this text and something in your messaging stream and you're checking your email thinking I'm being so much more productive. And then you realize that you just missed an important detail, but you can't lean over and ask somebody in the meeting what it is, cuz you're by yourself. And so there's all this pressure. And of course that moment that you're ready to unmute is exactly when the mailman's delivering a package and the dog is barking in the background. So also with this, with this kind of idea of Zoom fatigue, it's also this thinking about the way that we process information. So if we were face-to-face having a conversation, we'd make eye contact, but you would look away. You might see what else is going on around you in that space. But when we're on these different calls, regardless of what platform you're using, there's now this pressure to constantly be looking at the camera and feeling like if we aren't looking at the camera, people don't think that we're paying attention. That constant gaze not only makes us feel very uncomfortable and can cause tension in our muscles in the way that we're sitting, but it's just very exhausting. So it's this also, there's a lot of research showing that we spend a lot of time looking at that small window, that picture of ourselves, which also can make us, but it makes us hyper-aware of every expression that we're making. Oh, I didn't realize that maybe I haven't had that hair appointment and that doesn't look so great and all these other things. So when we're not having these visual breaks, it's hard and we get much more fatigued. But there are things you can do to help to remedy that.

So what would you say are a few tips that we can start to incorporate to help that?

What— well, I say these— there's a difference between easy and simple. So in the sense of one of the first pieces is truly avoiding the multitasking. What we find is that when we're switching back and forth between tasks, this concept of task shifting, it actually can cost you as much as 40% of productivity because your mind constantly having to reset on things. So it is useful to close tabs or programs that may distract you. Maybe we're going to minimize the picture of ourselves at this point of what that looks like. Also building in breaks. So take a mini break and it could be even just if you know that you're going to have back-to-back these Zoom calls and you're not going to be able to really get around it, maybe schedule a minute for 25 minutes instead of 30 or for 50 minutes instead of an hour to give yourself a few minutes to do that. Also in terms of, as we said, you know, the multitasking, on-screen stimuli, kind of combating that mental fatigue. It's also okay to switch back to phone calls or to emails. I'm sure some of your colleagues, if you said to them, I really need a break from a video call, they would commiserate and understand. But now people feel this need to do everything with a video call. And maybe that when you used to work with a client, you'd pick up the phone and connect that way, but now this new norm is setting in. So it's okay to reset and go back to that of understanding that we might want to connect in other ways. Get up and walk around. If you're on a conference call, a lot of people are just walking outside for a few minutes or around their place instead of sitting all day, whether it's a stand-up desk or just put your computer on a few books so that you can stand a little bit higher just to shift your position. Just those little bits to realize that sometimes the fatigue isn't physical fatigue, it really is that mental fatigue.

That's great advice and actually brings me into the next area I wanted to talk about. Which is what can we do as far as exercise or stretching or meditation? You know, what other habits that can we start to create that will help with this anxiety and to give us a break from being sitting at a computer all day long?

That's a great question. We know that exercise in general is a good natural release and a way for people to channel energy, and that many people find it helpful for processing, focusing, clearing their mind, working off stress. Steam, not to mention when we're physically active, it makes us feel more tired, which makes it easier to fall asleep faster. So for some people, it may be cardio. I've had some folks that I've worked with that are literally once an hour, they're setting a timer on their phone and getting up and walking around the house or going up and down stairs, coming up with creative things to do in their house. A lot of people are finding yoga, meditation, mindfulness exercises, even if it's a quick 5-minute break, there's some opportunities called grounding, which are some exercises that help to shift your thinking to something more concrete for a few minutes to distract from the anxiety and the stress. So we see a lot of folks engaging in those types of activities, also taking advantage of online, the 5-minute Pilates quick workout or a dance class or a barre class. And a lot of people are switching to doing things like having a heavy bag or doing some boxing and things at their house if they need something more physical to get out the energy. So the idea is to have these creative routines instead of just completely stopping the exercise altogether.

Well, you've given so many tips so far, but another question I have generally about working in this environment is how do you suggest that folks avoid burnout? I mean, they're working all day long, hours are suddenly blurred, you're trying to manage your family life, and your workplace in the same space, you know, what can we do to avoid that burnout?

Sure. I think what you highlight is new for a lot of people, but I also want to remind some of our hardworking folks that this has actually made matters worse for some that were already really bad at the work-life balance and setting boundaries. And so we see are these, as you said, these added pressures are for a lot of, especially junior and younger, you know, of our advisors and partners and such, there seems to be this fear that people think that you aren't working enough. And if they can't see you or feeling this pressure to respond really late at night or early in the morning. And so that's one of the first pieces of recommendation of advice is to really set routine normal hours. Yes, we may be getting a bit more sleep because we don't have the commute or we're not getting up to get kids on a bus or those other pieces, but trying to stick to somewhat of a normal work routine. And I do understand that for a lot of folks that the normal work hours aren't a 9 to 5, and that's fine. We've done that our whole lives in terms of these unique schedules. But if you generally even have some bit of a routine, if you got up in the morning and you showered first and you listened to your podcast, doing some of those things to get the body back in that routine, resisting the urge to roll out of bed, checking your email, and you realize 4 hours later that you haven't showered yet. Or after dinner, immediately going and sitting down if that wasn't part of your previous routine. Another bit is really setting up your space for work. What we found is that people initially thought, okay, I'm going to work from home for a few weeks, maybe a month. And so they never really got settled. And for a lot of people, it can be very stressful and anxiety-provoking to not have a concrete space where they can go to, and that's their boundary for when they're working and feel like they're able to leave it. And so really being uncomfortable or not having that proper setup can cause a lot of that added stress and contribute to that burnout, not feeling as productive. But remember, don't have that space be your bedroom. We want to stay away from your bed. And I think another piece for avoiding that burnout is really being able to be a little bit kinder to ourselves. Many times we're feeling like we're not doing enough and we always need to be on and that we just can't even take that 5-minute break. So, Setting boundaries and limits, being able to get some of that activity and exercise, establishing that schedule and routine. And it is okay if you need to take one mental health day just to have a little bit of downtime and regrouping.

The next area I want to talk about is that the advisors listening to this podcast aren't just looking for ways to help themselves, but, you know, they're emotionally supporting their clients, their clients' families, and their own families. Many of the clients in the past 4 months have felt fear or uncertainty by market changes and the economic landscape ahead, perhaps the election. Any ideas you'd offer advisors when giving advice to their clients? You know, what can they tell them about anxiety and the future, and what coping mechanisms can they recommend that their clients use?

I think that's one of the wonderful characteristics that we see from our advisors is that they genuinely care about their clients. They do wanna be there for them and they feel their stresses even pre-global pandemic and everything else that's happening right now. So continuing to do the things that they already were doing well in the sense of speaking genuinely, continuing to be that trusted advisor. A big piece really right now is listening and that so many people recognize that we may not have all the answers, but they wanna feel heard. They wanna feel understood, being able to really reflect back, paraphrase, helping them to know that you're hearing where they're at is one big piece of it. Additionally, helping them to see the longer-term perspective. So instead of just being concerned with the short-term right now, possibly even a gentle nudge to sometimes limit social media. It is important, of course, to get all of the information and to stay up to date, but it's really easy to get pulled into this overwhelming, ongoing, constant inundation, which can breed more fear and anxiety. Some specific things that our advisors can do, one is reframing the issues positively. So it's not about telling the client just, it's gonna be okay, or don't worry, but give them concrete examples, helping them to see that there was a time before where maybe they were stressed about a financial situation and how they were able to work through that. Helping them to be focused on doing problem-focused, specific, concrete pieces, discussing and attacking the problem directly, and really hearing if there's an area that they wanna talk about, that right now it may not be where the advisor thinks they should be focusing their attention, but being a little more aware and cognizant that maybe they just need to hear the client to express that piece. To-do lists can be very helpful for the client to feel like there's at least something practically they're doing, even if it is coming up with a concrete list of what their initial priorities are. A big piece too is providing a safe place for these conversations. You know, financial advisors, aren't the therapists, but they do offer a safe space to be able to think through these pieces and to talk with them and to help them to know that there's a place where they can express their concerns without feeling weak and additionally offering the support to do it together. Right now, everything can feel overwhelming. And when somebody is anxious, it's much more difficult for them to process information. So sometimes slowing down a bit, maybe realizing, not underestimating the power that advisors have of being that teacher and that support And then of course, recognizing small pieces of growth. So even if it's the little bit of progress, that honest compliment or acknowledgement really will go a long way when there's so much negativity right now.

How about for staff? Is that any different?

I think it's all still the same thing because we're all as humans experiencing the same stress and anxiety in different pieces. It's just that when you are the manager, when you're the director, being cognizant of the fact of what they're experiencing and being able to recognize that, they probably need some concrete information of what expectations are, or being a little more aware that just because we may be responding to an email at 10 o'clock at night, letting our staff know that that doesn't mean that we expect them to respond to it, or if we do, setting those accurate expectations ahead of time, but also being aware that there are going to be certain conditions where they're going to be experiencing burnout, maybe switching or giving them the option if they'd prefer to do a phone call or an email or a quick check in on Teams or Slack or whatever device instead of the Zoom. And just to be able to have some of that flexibility and recognize as much as we're doing it for ourselves, that they're also experiencing those pieces.

Melissa, diet is clearly a huge component of our physical health, but also our mental health. What dos and don'ts would you give us about the various diet culture phenomenons or sugar, caffeine, and alcohol even in this pandemic?

The biggest things to really think about is the reason we want to watch foods that are high in sugar, high in caffeine, is they can actually increase heart rate, affect levels in the body, triggering the fight or flight response. Most people don't realize that it actually takes on average 7 to 8 hours for the body to process the caffeine in one cup of coffee. So when you're having that after dinner coffee and then you want to go to bed an hour later and you're wondering why it's hard to fall asleep, or if it's not affecting your sleep, your tolerance is probably really high to caffeine at this point. And from the alcohol standpoint, there's following in terms of healthy use and age-appropriate and all those pieces. But it's important to recognize that a lot of people right now, they were having more drinks doing virtual cocktail hours to wanna connect or feeling so stressed at the end of the day and wanting to use alcohol to combat that or thinking, well, if I have a few drinks, I'm able to fall asleep faster or better. But what a lot of people don't realize is that that actually is a negative impact on your sleep. Specifically, for a lot of individuals, having those drinks close to bedtime disrupts your body's ability to get into deeper stages of sleep for your body to repair, into other stages, REM sleep, for your mind to repair. So unfortunately for a lot of people, that using alcohol, especially later in the evening or higher quantities, to try to relax themselves and to try to fall asleep has more of a negative impact and effect on both of those things.

Well, this has been a fascinating conversation, Melissa. So I really appreciate you coming on and talking with us today. Before we go, in typical Barron's fashion, we would want to ask you to end with one final actionable idea, you know, a piece of advice that this audience can take away and start to utilize in their day-to-day life.

So I think as we said at the beginning of the conversation, everyone is being affected. So to take away the pressure to be perfect when navigating completely new circumstances, but trusting their experience and instincts. You don't have to completely reinvent the wheel. Your clients have trusted you through their stresses and difficult times before. And so really balancing the confidence with flexibility, knowing that a large part of resilience is a willingness to pivot while also being more mindful of self-care and making sure that we're as diligent about recharging our own minds and bodies as we are with keeping our phones and computers at full charge.

That's a great actionable idea, Melissa. Thank you so much. And thank you for coming and being with us today.

Thank you so much, Allison. I'm happy to be here.

Well, thank you all for tuning in. We'll be back next week with another newsletter and episode of The Way Forward.

This podcast was brought to you by Wells Fargo Advisors. Looking for a firm your clients can't outgrow? Wells Fargo Advisors offers financial advisors full balance sheet solutions with wealth planning, investment products, banking, and lending that meet the needs of affluent to ultra-high net worth clients. Build your practice your way and on your schedule with independent and employee model options designed to meet your needs today and tomorrow. Learn more at joinwfadvisors.com.