Mental Health Challenges in Doctors Anxiety Insights and Solutions

Well, we expect them to turn up each day smiling, happy, you know, regardless. They're human just like we are. They have their family issues. They have their health issues. You know, they might have a back pain. They might have a headache. They might have who knows what. But we expect them to be there shining and, you know, smiling and absolutely on the ball.

Hello and welcome to Beyond Diagnosis, a podcast to raise your awareness, Decisions and voice for alternative practices so you can take back control of your health. I'm Rita De Michele, your host, a mindset and empowerment coach, and the founder of the Onus platform. Join me each week so you can create the health of your dreams. Is anxiety the commander in your decision-making? In the experiences you have in life, for the goals you want to achieve. It can express itself in many ways and doesn't discriminate who it affects. To help put you back in control of your life, I'm speaking with Gayle Comodi, a health coach who is pioneering and addressing mental health change for healthcare professionals and the general public with anxiety. Hello, Gail. How are you?

Hi, Rita. Um, well, thank you. Thank you for having me on.

Oh, you're welcome. We've been having a great pre-chat all about anxiety and healthcare professionals, and you know, it's an area that is really emerging for you as a health, you know, health coach, you know, in this space, a mental health coach in this space, you know, within the healthcare framework. And, uh, you've been a registered nurse for a long time in the— in that sector, you know, also in hospital management. So you've kind of seen firsthand the emotional and physical struggles that actually come with anxiety. So is there a particular reason why healthcare professionals in general experience anxiety more than other professionals?

That's a good question, Rita. I think that from my experience, it's the fact that the personality of many healthcare professionals, and particularly doctors, is they have a trait of perfectionism. And they have— this therefore gives them very high expectations. expectations of their achievements, their goals, their outcomes, their patient care, and personally for themselves, their image and representation to the community. Yeah, I think that that's the underlying reason for it and the expectation probably by themselves and families of them to achieve.

You can kind of understand that though, don't you? Doctors are held with such high esteem in Like you know, if you're a doctor, all of a sudden you've got instant credibility, you've got status, you've got everything. And apart from that, also on their part, they're taking people's lives and health into their hands and feel responsible for it. So you can imagine the anxiety that that would bring, you know, to someone who feels, you know, if this doesn't work or if I've taken someone down the wrong path. or what I've prescribed has caused something else. Everyone's human. You would feel, uh, responsible, you know, for the outcome of that patient.

That's very true, Rita. Um, I think they have— it's even more important than, say, if you were the financial manager or bank manager or whatever. You wouldn't have that same level of responsibility as a, as a human life.

Yes.

And then a lot of the work they do is very intricate, you know, going into the brain and the heart and all these very specialized areas of humans. So to have— be perfect in the outcome, I guess, for the patient as well is very important. So there is a lot of expectations beyond themselves by the patient and even their colleagues. Um, there's— and they're the people they're training, there's this huge expectation. So yes, there's a lot of pressure put on them, and so that in turn creates that anxiety.

Yeah, it would. And do you feel, Gail, that, um, people have a misconception that doctors or any kind of healthcare provider Has it all together. Yeah, you know, that's the, that's the pressure in itself, isn't it? That we think, oh, there's never anything wrong with them, there's never anything mentally wrong with them, you know, they're like, you know, they know everything, because we do put all our, our charge into their hands. What do you say to that?

Uh, so we have to keep in mind too that they're human and they have bad days like we do as well. But I guess it's the expectation that we want a good outcome from them. And I think in general, they do present on a fairly even emotional keel when they present to the patient. I think it's internal anxiety they have rather than displaying it openly.

Yes. Yes.

They are only human. So we have to keep that in mind when we go to them as well.

When you're in a coaching session with a doctor, what is one of the most common complaints that they're experiencing? You know, anxiety. But what are they saying that they feel their anxiety is mainly fueled from? Is it the care for a patient, or is it from other colleagues, or what is it?

It's a variety, Rita. It's a variety. They work within that health system, and that is a big chunky animal, the health system. And it can either chew you up and spit you out or you survive in it. So it's not just the doctor turning up each day just for you or me to give us healthcare. He has to function at home with a family, has to function within this big system with his colleagues, with education, with all these massive expectations way beyond just sitting here looking after you or try. So there's a lot of pressure put on them. So it's the multifaceted aspects of their life. So it's mainly time. There's a lot of expectation on their time as if they've got 48 hours in the day, not 24, to give to their institution, to give to meetings, to give to research, to give to all these external things. that they're not actually paid for. So there's a lot of expectation of their time as well as their expertise and them as a human. It's interesting to know that there's actually double the amount of doctors commit suicide in Australia per year than the average population. So that's how much pressure's put on them.

Well, I would never have thought. That's a staggering figure.

And it's hidden. It's not spoken about. So oftentimes, when something comes up that someone's passed away, it might be the internal hospital newsletter. It always just says, oh, sadly, and families will miss them. Never gives any reason. It might be a 32-year-old, might be a 28-year-old. And you always know through that that it's been some misadventure for that poor person. So it's them at a very early age learning to cope in this massive big system before they even get to be the doctor that sits in front of you when you go for your appointment. So they've got to come through a long road, arduous road to get to that point. So there's all that time for them to build up the anxiety, all that time for them to be expected to perform at their maximum and to be perfectionists. So it's not only their initial study time and getting into medicine, it's this whole track of time that takes them up to 10, 15 years to get to where they want to go. A lot of, um, uh, working within the system. There's a lot of interviews, there's a lot of exams. So there's always this continuous, um, uh, things put upon them that they need to obtain and reach before they even get into that chair and sitting before the patient or doing their surgery or whatever they choose to do at the end of the day. And then within that, they still have to live life. So it's not just them going into that healthcare system and being that doctor. They also have to be human outside of that as well.

It's a lot. It's a lot. And even though the podcast does fun— uh, does focus on functional integrative doctors, practitioners, complementary, alternative One of the common, um, well, comments really that you see on social media and across Google, etc., about doctors and why people are also turning not only for the root cause to their concerns but are also turning away from the healthcare system and doctors is because they complain so much about their bedside manner, or that they've been, you know, gaslit, or that, you know, they don't have any time, that, you know, you can't get to the bottom of things. Well, now from what you're saying, it can really open up people's understanding of what doctors actually go through. They have to, you know, um, well, get certain KPIs. They have— well, if you're in a hospital, you do. They have to, you know, work in the constraints of Medicare. They have to have so many government rules and regulations. You can just imagine. So when they're stressed, and maybe on top of it like the subject of this podcast, they're also really struggling with anxiety and being just human.

Yeah.

I understand now why sometimes— not that I agree with it, but that they're really short, that they've only got that. Just when someone's speaking to them, it's like, get to the point. Like, don't give me the fluff, just get to the point. Or, you know, that can't be. Or that they stick within what they know. You can understand now why it's so challenging for doctor and patient relationship when you're under that much stress as well.

I think so too, Rita. But I think as we'll discuss a bit further about strategies to manage anxiety, I would think that it would be fabulous if these— if there could be extended education for doctors and modules put into their learning about alternative ways to manage their anxiety. I think that's the important point. We can see where the anxiety comes from, uh, and how it develops, but they're not given any tools on how to manage that differently.

Yeah, that's so important because that bedside manner and that patient-doctor relationship is paramount for better outcomes for the patient's health. You know, especially, I believe, for women.

Very much so. And it's spending time communicating because when the patient feels that the doctor's, you know, a little bit tense and in a bit of a rush and let's get this done, then the communication breaks down. So then the outcome for the patient's not as good.

Yeah, that's exactly right.

Communication both ways isn't effective.

And that's why so many leave a doctor's appointment and think, well, that was a waste of time.

Yeah, it's because the anxiety's experienced on both sides due to that lack of communication. So, you know, I think as a part of that, as I said, that education for doctors should include a lot more of the alternative modalities in managing themselves, their anxiety, and their life. And I think that would improve so much that Communication with an understanding and outcomes for the patient.

Yes. Well, for me, from what we've just been discussing, for me, and I really hope for everyone who's here with us today, it really highlights the need to become fully conscious, aware, and educated about your own health condition, what you are experiencing, and bring that to an appointment Take responsibility yourself and advocate for yourself, because as we said, the doctors are only human. They're stressed. There's probably so many of them from that stress have developed anxiety. What's your opinion about people advocating for themselves when they go to see their health provider?

I think it's absolutely necessary. Absolutely necessary. Everyone should be aware of their own health and their health needs. And today you've got the availability of internet, which may not give you all the correct information, but it gives you a broader idea of what your complaints could be. I think that you need to educate yourself and be fully aware of your own body, because when you do that, you actually give the doctor a better starting point. When you just go in quite vague and not really knowing what you want or what the outcome should possibly be for you, They have to start from scratch and it's just so much harder for them. So I think it's really important for everyone to take responsibility for their own health. And maybe Western medicine isn't the route for them. Maybe they need to look at alternative ways of managing their health. So they can make that decision though, if they're more responsible for their own health and their health knowledge. So as you said, Rita, people being aware of their own health before going to the doctor, I think that's so important. And I think it's important for their whole health journey, not just going to Western medicine.

Yes, it is, it is. And it's the— it really is my hope and desire from interviewing professionals like yourself on this podcast, is that it starts breaking down the old way of, I don't take I've got no idea about anything about my health. I have this condition, it's just appeared, I don't know anything about it. I'm going to a doctor or an alternative practitioner and they're going to give me all the answers and they're going to cure me or they're going to help me, or— and I don't need to do anything. That, you know, like all the pressure is on them. I don't take responsibility or in control of myself. I hand over everything for someone else, for it to be in their hands. And yes, we do need obviously their guided help. That's why they are where they are, all the study they've done. And it's your body, it's what you're experiencing, and you need to go there, like we said, informed. I really hope that that old way of you can't question a doctor, you can't say anything to a doctor, they know everything, is moving out of society? Because yeah, I think it really has to.

I think that's an important point. And maybe it's slowly moving. I think with the newer, younger doctors, they're being— they're more aware of that. Um, so I think that will eventually move. But I think as the patient becomes more assertive and responsible for their own health, I think that paradigm will shift as well, and they go in and they ask questions.

Yeah, well, health has become, you know, it has— the desire for people to take control of their own health has skyrocketed in, you know what, the last 20, 30 or so years. But for many people in the last 20 years, you see it on social media So, you know, a new age is coming, a new era is coming, which, you know, I celebrate wholeheartedly. But like I mentioned in the intro, anxiety really doesn't discriminate. It doesn't just affect the professionals, it affects anybody and at any stage of life. I know that in my family and personal experience, I don't feel I Struggle with it at all now compared to when I was younger. One of the reasons why I went down the alternative path and started this podcast and everything was also for my son's anxiety, which he's very much come, you know, coming out of.

Hmm.

It can start in early life. You can be born with a familial history. It can happen after an event. Or like you say, the pressures of studies and becoming a professional. What are some of the root causes for that? For anybody listening who feels like, I feel like I'm a bit anxious, I've read it on Google, I feel like I can tick some of that, I've done a quiz, I can feel like I can tick X amount of boxes. What's the root cause? For anxiety?

Uh, majority of, uh, root causes for anxiety is, um, often a— some negative or traumatic event. Uh, and it doesn't have to be childhood abuse or anything like that. It can be just from, um, failing an exam, and the expectations partly can come from that. So then when you go to sit another exam, you're so anxious you fail again. So it can be as simple as that. It's, it's a, a negative event that's happened to us, whether it's traumatic or not traumatic, it's still a negative event. And that actually stays in the subconscious. That's why it's so strong. And that's why it keeps playing out in all the future events that happen or a repetition of, of what that event was.

Mm.

So, but for, um, adults, it's often around all those core things of our life, relationships, money, uh, health, and our work or career. So we think about stresses in those areas and then we become anxious about them.

Hmm.

So it can come on in adulthood. There's, in Australia, there's approximately 30% of the population have experienced or do experience anxiety. Uh, so that's quite a high number. But overall, um, there's, uh, around 1 in 4. So that's around the 20% that have it.

Constantly.

Yeah, constantly. So the thing is though, Rita, it becomes, um, what I've learned from some of the work from a well-known psychiatrist in America, it actually becomes a habit.

That's interesting. Anxiety as a habit.

Yeah, it's— so it's a psychological habit. So what happens is we actually get a reward at the end of being anxious, and that's what keeps us addicted to the behavior. So, um, it's something that we can certainly change, but we need to be aware of it before any change obviously can ever be made. So yeah, it becomes, um, what he refers to as a habit loop. Um, and the habit loop has 4 steps to it. So, um, I don't know if this is the time to talk about it, but that's—

Just a little brief overview of what those 4 steps are so people can become aware if they're doing one of the steps.

Yeah, well, they usually do the 4. The 4 go hand in hand.

Oh, they go hand in hand.

Okay, but they don't realize that's what's happening. But it all starts with the thought, the original thought. So the thought can be driven around whatever your stressor is with, um, work, finance, relationship, or health.

Hmm.

Whatever that stressor is, which, um, for many develops— the stressor develops into anxiety. So that's that thought, and that thought then sets off emotions. And the emotions are a cocktail of chemicals released from the limbic system or the subconscious mind. And that cocktail of chemicals drives our neurotransmitters and becomes a reaction. And so in the case of anxiety, the thought might be, oh, I don't have enough money to pay my bills, or I'm always in bad health. I don't know how to get better. So it sets off this same cascade of chemicals, which gives us the same reaction, which is anxiety. If that's the case, it can be other things, anxiety. But at the end of that, it gives us a reward, and the reward is dopamine. And it's the same process that happens. People don't realize this is, um, the same process that addiction goes through.

Right.

The thought for whatever you need, the emotion sets off the chemical reaction. You take the reaction, which is taking the drug or having anxiety, and it gives you, um, a reward at the end. So people don't realize that this is what's happening internally. So it's so strong internally.

Usually I associate dopamine with feeling good at the end, like feeling good. I rarely see people who have Anxiety that feel good.

It still gives them the reward, whether it's negative or positive.

It's still a feeling.

So the internal physiology goes, oh, thank God I've got that feeling. Rita, that's a great point about feeling anxious, dopamine making you feel good, and you can't see how anxiety makes people feel good. It's not actually what happens on the external, it's the what happens internally. So that chemical cycle is— that's, that's a great question. or pick up there, Rita, on the dopamine and the anxiety. Whereas dopamine gives us a good feeling and anxiety, obviously people don't like that feeling. But what happens is the whole, that whole chemical cycle I'm telling you about, that happens internally. And that's where the dopamine comes in. It's actually, it's very complicated. I can't explain it here, what happens in the brain itself, because It's a whole hour on itself, what actually happens to create that, that simple scenario I've told you about. Um, but the brain holds you in the state of anxiety until it gets the dopamine. So, or whatever that negative feeling is, or even the positive feeling, it holds you there until it, um, the dopamine is released. So But there's a whole physiological process happens in the brain that does that. But all can be changed if you're aware of it.

Yes. Yes.

Then you can start realizing what's happening and start making change. And obviously any change, because it's an old habit that's been repeated and put into place, and particularly if it's a childhood trauma or negative experience.

Gail, that's so interesting to hear that it's very similar To liken addiction. So what are the 5 common symptoms for anxiety?

The most common ones are fear, doubt, worry, um, dread, uh, and then that gives us things such as reducing our concentration, and often that's due to distracting ourselves. And then you get all the other physiological side effects such as being sweaty, fast heart rate, feeling nauseated sometimes, and irritable bowel and those type of things. So they're the main symptoms.

You know, it is hard. It's really debilitating for people, isn't it, when you feel that you can't go outside Because you're feeling these feelings, and then you see a professional who actually believes that it's incurable, but you don't actually agree with that. So what are some of the strategies that you help your— well, doctors and people in general with that they can use to manage or actually get over their anxiety for good?

So Rita, there's all the strategies are simple. They're really simple, and it just takes people to be aware and practice. And the main practice is breathing, our breath.

Okay.

So, and it can be done anywhere. I tell the doctors if they're in the middle of an exam or in a difficult family situation, just to sit quietly, and it only takes 12 seconds. So they can take 4 deep breaths in through the nose, Hold for four to the count of four, and then slowly release the four breath out through the mouth to the count of four. So it's only twelve seconds, and obviously if you can do that a few times it's better. But just to do it once breaks the state. Okay. So the second strategy reader is also very simple. Once again, it requires awareness. So when you're aware that you're starting to go into this anxious state. You, um, pause for a moment. Then you, um, take notice of what that thought is. And you can actually in that moment change that thought or recalibrate.

Fascinating.

This is where you take control. This is where you take control. Okay. Take a breath. Once again, breathing comes into it. And this one can just be one in through the nose and slowly out as if you're blowing out a straw. Um, and that will change your state. So what do all these strategies do? They actually break the state within the brain between those sympathetic and parasympathetic nervous system.

Hmm.

So the sympathetic puts us in flight and fright, and the parasympathetic puts us in rest and creativity. So it's actually just that simplicity of switching from one to the other. And a lot of your other podcasts have covered off a lot of these areas in alternative health, which is really great. So it's just how you use those with simple methods like breathing, awareness, pause, breath. And that's even with the 4 breaths, you know, in, hold, and out. It's the same thing. It's sort of a pause, awareness, pause, take an action with the breath and it breaks the state.

Yeah.

So they're just 2 simple things you can put into play, but I always recommend that you start practicing these things well before you get into the anxious state. Don't wait till you get into the anxious state, because if you start practicing them, I even encourage people to set their phone every 2 hours and practice it through the day just once or twice.

Yeah.

Um, so that it's already set here in the neural pathways. When they get into the anxious state, so they can automatically just put it into action. So it just comes into play without them thinking, now, what was that step? How do I do that again? Uh, it just comes into play because they've already practiced it.

Yeah.

So very simple.

Preventative. That sounds preventative. Instead of dealing with the actual anxiety at the time and waiting for it to build up, you're negating it by being preventative. I mean, you still almost probably have an anxious response, but maybe not as severe that you would have had. Yes.

And that's also taking control, Rita, of your own health once again. Um, and that by practicing this, it actually leads into negating the anxiety altogether. Because when you get to what was previously an anxious state, you think, oh, I know how to deal with this, and you just put it into play.

Yes.

So how you lose the anxiety, that's how, by repeatedly practicing these things.

So that's like when, um, they say learning how to soothe yourself.

Yeah, similar principle. Yeah.

Gail, that has been amazing, and you've given so much information and helpful tips throughout this whole interview. For people with anxiety, or to understand if they are, you know, have elements of anxiety, whether they feel like they're developing anxiety due to an event. What is your best piece of advice you could give to someone today to help them, A, to help them calm themselves?

Uh, as I said, Rita, I really think the breath, breathwork, is that because it's so easy and so, um, simple to implement. So even if you're an anxious mom or whatever, and you, you can just say, okay, I'm going to take a moment out here and just do some simple breathing. And you'll find it'll break that state. It's just doing simple stuff that's quick and easy and becoming a part of your daily habit. I think is the best advice.

And not to complicate it.

Not to complicate it. It's, it's, we as humans love complicating everything. Yes, we love complicating everything. Come back to simplicity.

Because that's another whole episode really we could talk about with you. You know, I, I think there's a lot of, you know, self-worth, self-esteem, perfectionism that fuels these anxiety feelings, the feelings of anxiety.

Yeah, exactly.

Yeah, decomplicate things. There's so much value in keeping it simple and not worrying about what other people think and just, yeah, living your own life.

Exactly.

Gail, this has been so helpful. Thank you so much for coming on the show and, you know, also educating everyone about doctor's situation. You know, so maybe a lot of the judgment and frustration towards doctors, um, can be lessened and people can take responsibility for themselves and their interaction with a doctor.

Yes.

To feel more empowered so they don't walk away from an appointment feeling, you know, a little bit victimized, you know, that they feel— have a little bit like, that was rubbish, or why me, or it's always like this, you know. Actually take the control, maybe unders— have of understanding, compassion of what's happening on the other side. And that, you know, not everyone's got it together, including health professionals.

Exactly. That's exactly right. And the other important thing is to take responsibility for our own health as well, not hand it over to somebody.

Yes.

For us to take ownership and think about ways we can heal ourselves too.

Absolutely. So if you do have anxiety, or if you know of a doctor or a health professional who does and is struggling, please reach out to Gayle. All of her details will be in the show notes. You can contact her, book in, and she can get you on your way to a much calmer life. Thank you.

Rita, thank you very much.

You're welcome.

Thank you. Thank you.

I would love to know what was the biggest insight or aha moment you got from this interview so you can now speak up, take action, and make informed decisions for your health. And if you like this episode, get instant access to your free ebook, Alternative Taking Back Control of Your Health at life-onus.com.