Brain health

Memory and cognition

Dr Sarah White: I’m joined today by Dr Marita Long, who’s the Honorary Medical Advisor for Dementia Australia, University of Melbourne lecturer, and also a GP with a special interest in women’s brain health. So Marita, that’s a long list of interests.

Dr Marita Long: Yeah, I suppose I’ve been accumulating an interest starting out in general practice and seeing lots of women. So it’s a natural progression, I guess, to go from women’s health to now think about cognitive health.

Dr Sarah White: And you’re also a board member of the Australasian Menopause Society.

Dr Marita Long: I am.

Dr Sarah White: So we’ve worked together on that.

Dr Marita Long: Yeah.

Dr Sarah White: That’s great. Now we’re actually talking about memory and cognition today. So I think most people understand what memory is, but how do you explain cognition really simply to people?

Dr Marita Long: So if we think about the broader ranges of cognition, social cognition is a really important one. So that’s ability to socialise, to connect with people. Attention is something that is really important. So being able to multitask or follow a story, a conversation, a movie, for example. Then we’ve got perception. So that’s, I guess, putting things together, in a sense. So what’s coming in, what we’re making sense of. And that can also involve doing things, like being able to do tasks that we’ve been familiar doing. Language is another part of cognition, really important part of communication. So we can see some changes in people’s fluency or ability to initiate or participate in a conversation. And then you’ve got learning, so that’s the ability to take on new information and learn new things. And then executive functioning, so that refers to that higher order thinking, so judgment and planning. You can see there’s a broad range.

Dr Sarah White: That’s very broad. So it really is how the brain is working in your everyday, every day, right? So when you talk about brain health, as I’ve heard you talk about, you’re really talking about that ability to keep cognition going and happening properly. Is that kind of, in a really, sort of, bad explanation?

Dr Marita Long: No, that’s exactly it. It’s being able to keep your brain nice and healthy so you can participate in life, really. I think the important message is that for cognitive health, it’s more than memory. So someone’s memory might actually still be intact, but other areas of their cognition might be failing. So we have to think of it more broadly.

Dr Sarah White: And that’s really interesting because sometimes I think women, particularly at menopause, get worried because you, I, miss a word every now and then, or like, ‘Where did I put my car keys?’ That is about cognition, right? So how do you know if it’s something that’s situational, you know, I’ve got a lot going on at work, or I’m stressed, or something like that, versus normal ageing? So I presume our cognitive function, like our physical abilities, decline as we get older. How do you know when something is not right?

Dr Marita Long: And there’s the sort of million dollar question, isn’t it? So I think when we think about normal ageing, and that does happen to everyone, that starts actually in our third decade of life, believe it or not.

Dr Sarah White: Thirties, really?

Dr Marita Long: So our memory starts to lapse a little bit, our processing speeds start to slow down, but our skills and knowledge and life experience allows us to keep up with those cool kids still. But about 50, we do start to notice that things are changing, and that will be forgetting someone’s name, for example, forgetting the name of that book you want to recommend for someone you just can’t get. It’s on the tip of your tongue, but you just can’t get it out. Sometimes things becoming a little bit more difficult to manage, things that you’ve been doing very easily might just become a little bit harder. You’ve got to pay a little bit more attention. I often think about doing a flat pack. So when you got—

Dr Sarah White: Flat pack furniture?

Dr Marita Long: Yeah. You know how challenging flat pack furniture is?

Dr Sarah White: Right, yeah.

Dr Marita Long: So it might be that you’re doing that and you’re finding it, it takes you a little bit longer and it’s more difficult than it once was.

Dr Sarah White: Okay.

Dr Marita Long: So that’s kind of normal, but you’re still able to work and socialise. It’s not impacting your ability to perform your duties at work or to maintain your social connectedness and your, I guess, enjoyment in life. You’re not having to withdraw from things because it’s becoming harder. So everyone goes through that.

Dr Sarah White: Men and women, it’s not just this menopause thing that everyone talks about.

Dr Marita Long: Yeah, men and women. And it’s a sort of a very slow change. There’s nothing dramatic. You don’t see dramatic changes. So that’s normal.

Dr Sarah White: Okay. So if we all get forgetful as we get older, asking for a friend, what are your top tips for remembering things?

Dr Marita Long: Okay. So I think when we’re thinking about normal ageing, I think the first thing is that we do need to normalise it. That some of these changes are happening. You don’t need to be fearful that that’s a sign of something more serious. So it’s really simple things, actually, like making sure you get good sleep, making sure you’re out exercising, keeping your body—

Dr Sarah White: That’s important for brain health as well?

Dr Marita Long: Very important. The thing I love about exercise, too, is that it often involves social connectedness, doing things outdoors with other people.

Dr Sarah White: Sure. Really important as we get older.

Dr Marita Long: Eating well. So your brain can’t work well if you’re not eating well. So it’s going to be harder to remember if you’re not eating well. And of course not drinking too much. So we know that drinking has a big impact on people’s brain function.

Dr Sarah White: So all of the things that we kind of talk about for good physical health, good mental health, is also about good brain health.

Dr Marita Long: Absolutely.

Dr Sarah White: So we’ve talked about sleep, getting sleep, nutrition, physical activity, not smoking, not drinking too much. Are there any other things that we can do for reducing our risk of dementia, these modifiable risk factors? What else was there?

Dr Marita Long: So in fact, there’s 14 modifiable risk factors.

Dr Sarah White: That is way too many to remember, even if your cognition is super.

Dr Marita Long: So I think we think about them basically in terms of vascular risk factors. So when I refer to that, I mean things like high blood pressure, high cholesterol and diabetes.

Dr Sarah White: So they’re the things that, if you’re going to see your GP about your annual health check, that’s what they’ll be checking for your heart. So that’s a pretty automatic thing if you’re going to have those annual health checks.

Dr Marita Long: Yep.

Dr Sarah White: That’s helpful.

Dr Marita Long: We’ve just got to start thinking about them around the brain as well. And then we have other things like brain injury, so the importance of wearing helmets and seat belts so that you can limit any brain injury. And then we’ve got things interesting like hearing and vision.

Dr Sarah White: Hearing and vision are a bit surprising. Why do we need to worry about our hearing and vision as we get older?

Dr Marita Long: So it’s an interesting one. And it’s partly to do with, could that be, I guess, a sign that there could be something going on neurologically, or is it because we have less input? So if we’re not hearing well, we tend to not engage in conversation, we tend to not go out if it’s a noisy place because it’s difficult hearing. So that might then predispose you to being a bit more isolated, perhaps predispose you to getting depression. So hearing’s really important, and it’s a one thing people don’t like doing anything about.

Dr Sarah White: Oh, I think I might be guilty of that myself. Yes, going to see an audiologist and having your hearing checked can be expensive, but really important.

Dr Marita Long: Really important. And then vision, the same thing. So if you’re not seeing well, we’re going to be less likely to feel confident to go out, walk around, perhaps go to the movies.

Dr Sarah White: That’s true. Yes.

Dr Marita Long: Again, engage in that social interaction, which is so important.

Dr Sarah White: And if we’re talking about using our brain and we’re not reading because our vision is reduced, that’s also going to be really tricky to exercise your brain.

Dr Marita Long: Absolutely.

Dr Sarah White: Okay. Really interesting. And is it a case of just recognising the need to be a little bit more organised? You have those task lists, use your diary, just to not expect that you can just juggle it all mentally. Because I know, myself, you get to midlife, it’s got the child thing, you’ve got family things, you’ve got more work things, and I just wonder whether it’s me forgetting things or it’s also just, there’s just so much more to juggle now.

Dr Marita Long: And I think, when you were younger, you could sort of keep in your mind what social events you had coming up and what the work deadlines were, much easier. As you get older, it does get harder. And I think it is just owning that and saying, right, well now I do have to start relying on that diary. We’re lucky now we have electronic diaries. It’s a lot easier, isn’t it, than lugging around a big black book.

Dr Sarah White: So if I can no longer expect to run 10 K in a certain amount of time, I can no longer expect to remember everything I have to remember. That’s reassuring in some ways, really.

Dr Marita Long: Yeah.

Dr Sarah White: Now the challenge of course is dementia. The rates of dementia are increasing, and in fact it’s now, correct me if I’m wrong, it’s now the leading cause of death for Australian women?

Dr Marita Long: Yep.

Dr Sarah White: When do we need to start worrying about dementia, I guess, or what are some of the signs? What are some of the first signs you might notice if you have dementia?

Dr Marita Long: And I guess this is again the take home message, just to remember it is more than memory, but memory is often the first thing people notice or what’s being noticed about people. So you just talked beautifully about the fact that using a diary is something that can be really helpful. So you are recognising you need to rely on a diary and you are using your diary. If someone had dementia, their memory would be changing, but they wouldn’t have that, I suppose, metacognition to be using the diary effectively.

Dr Sarah White: So they don’t realise there’s a problem along with the loss of memory. They’re not recognising there’s a problem?

Dr Marita Long: Potentially. Or they may not have the ability to put those supports or those structures in place to remember that they’ve got a doctor’s appointment, or to remember that they’ve got a bill coming up. So you’ll start to see that there is some change in function. So you are making some errors or some omissions, and that’s probably that, sort of, first sign.
But we can see other things as well. If we think about, I’m going to think about my dad, for example. He had dementia, so he used to love going out to Chinese restaurants. That was his favourite restaurant from when we were kids. That was our treat, we’d go to a Chinese restaurant. All of a sudden, he didn’t like going to Chinese restaurants and he would say, ‘I don’t like Chinese food.’ So it was a very strange change in him, because that was his love. And really what it was, he didn’t feel comfortable anymore in a noisy environment, in a place that was busy, where he might have struggled to remember the process of ordering, paying. So that was what was going on for him. So it’s those changes that should pique people’s curiosity to think, ‘This isn’t normal behaviour.’

Dr Sarah White: Right. That’s really interesting. So I guess one of the myths or the classic perception of dementia is, oh, suddenly someone’s forgetting everything. But it sounds like it’s a lot more than that. It’s not being able to have those conversations with people.

Dr Marita Long: Yeah.

Dr Sarah White: Yeah okay, right.

Dr Marita Long: So it might be that someone’s picking up a book and they’re reading a couple of pages and then all of a sudden they’ve lost that book. Or it might be the person who used to love watching series on television, but would be asking a housemate or a partner, ‘Oh, what just happened?’ ‘Oh, what are we up to?’ ‘Oh, which episode are we watching?’

Dr Sarah White: So is it often the people around you who will notice some of these signs before you’ll notice them yourself?

Dr Marita Long: Yeah, yeah. That’s often what we find. Often we find, in clinical situations, the people who are presenting, telling us they’re worried they might have dementia, are often having more dementia worry or anxiety around it. It’s often when someone else is bringing the patient in saying, ‘I’ve noticed that there’s some changes’ with mum or dad or partner.

Dr Sarah White: Very interesting. So in your work with Dementia Australia, what are some of the most surprising things that you’ve learned about brain health and ageing?

Dr Marita Long: I suppose the first thing is really understanding that dementia is a collection of symptoms, not a disease.

Dr Sarah White: Oh, I don’t think I knew that.

Dr Marita Long: And there’s lots of different causes of dementia, but dementia really refers to the symptoms. So in Australia we have Alzheimer’s as the leading cause of dementia. So that was probably, I guess that’s been one of the big things because we don’t think, we’re not taught about it.

Dr Sarah White: No, I did not know that myself. How interesting.

Dr Marita Long: So that’s one take home. I guess the other thing is that although there’s no curative treatments for dementia, working with Dementia Australia has really highlighted there is so much that we can do to help people who have been diagnosed with dementia, and people who are worried about their risk for dementia. So there’s a lot we can do to prevent dementia now.

Dr Sarah White: Now that’s what I’m really interested in, that prevention. What are some of the things that people can do, if they’re really worried about dementia, what are some of the things they can do to reduce their risk?

Dr Marita Long: So, great question, and I guess we go back to basics. So we go back to smoking, nutrition, alcohol.

Dr Sarah White: Not smoking.

Dr Marita Long: Not smoking, not drinking too much, having a healthy diet. And I don’t know that we have to particularly be fussy about what diet, but just having a broad, healthy diet that includes all the food groups, and keeping yourself physically active. So they’re the basic things. Sounds easy, doesn’t it?

Dr Sarah White: Well, that’s right, it does. But actually they’re often the harder things to do, aren’t they? We’d love the pill that we could just take.

Dr Marita Long: That would be lovely.

Dr Sarah White: Now tell me a little bit more about physical activity. I think one of the things we’ve learned from a lot of women that we’ve spoken to, Jean Hailes crew, is that physical activity is a phrase that we throw around a lot, but a lot of women don’t actually know what that means. If we’re thinking of a group of women who are 60 plus, say, 65 plus, when we’re talking about really good physical activity, what are we talking about for that age group?

Dr Marita Long: I mean, really for me, my thing would be finding a physical activity you enjoy, that might be walking, that might be gardening, that might be going to Pilates, and doing it every day.

Dr Sarah White: And ideally with someone, because social connection, am I right? That’s also really important for dementia risk?

Dr Marita Long: Absolutely. And the beauty of walking with someone else is you actually have to multitask. So you have to walk, you have to talk, so you have to be navigating a whole lot of things. So it’s really good for your brain to be walking and talking. And walking’s pretty easy, doesn’t cost much, pair of runners, go around the block a few times, walk around the garden. So I don’t think we need to get too caught up on ‘you have to be doing this or that’.

Dr Sarah White: So it’s not, you know, 30 minutes of really high physical activity. It’s just keeping active?

Dr Marita Long: I think if you went into all the breakdown of research and you’d get some people saying it should be HIIT, some people saying it should be strength. I just think if you can do anything that you enjoy, you’re going to be more likely to do it, so it’s going to be beneficial.

Dr Sarah White: Now, my mother does crossword puzzles all the time, or Sudoku, to keep her brain healthy. Is there any truth to that?

Dr Marita Long: Well, what we know is if you do a crossword every day, or Sudoku every day, you get very good at doing crossword and Sudoku.

Dr Sarah White: I can attest to this.

Dr Marita Long: But it doesn’t necessarily improve or optimise your brain function. So what we know, really, is you need to challenge your brain. Just like with physical activity, you do need to challenge yourself. It does have to get a little bit harder. It’s the same with your brain. So for someone who is in a very cognitive based job, for example, like me, so sitting in an office and trying to diagnose and help people with their various medical conditions, I would be better to go and learn a language or a musical instrument or a new dance routine. So use another part of my brain to really stretch my brain. Does that make sense?

Dr Sarah White: No, it does. Absolutely. So it’s a little bit like that ‘use your muscles or lose it’. So some of the things out there, there are lots of free language learning programs online, for example, that you could do, things like that.

Dr Marita Long: Yeah. So something that’s different that’s outside of your normal realm of cognitive activity is really important.

Dr Sarah White: Fantastic. What do people do if they are worried about dementia? Where would you go for information, for help, for diagnosis? What’s the next step?

Dr Marita Long: I think that’s a really good question to ask, and I think it’s worth spending a little bit of time just to focus on dementia worry, because actually dementia is now the second most feared condition for Australians.

Dr Sarah White: Oh, interesting. And that’s because, I guess, so many more people have it, people are exposed to it, or—?

Dr Marita Long: I think that probably most people know someone now who’s got dementia. We’re seeing a lot more interest in dementia risk reduction. We’re also seeing more famous people be diagnosed with dementia. We’re seeing it more in the movies and even TV programs where the protagonist has dementia. So we’re all becoming much more aware of it. And there’s an incredible fear and stigma around dementia. And that’s partly because, I guess, there’s no known curative treatments. And there’s been a really negative representation of people living with dementia in the past. And I think a lot of that comes down to just lack of understanding. And in fact, the World Alzheimer’s Report just recently published highlighted that 80% of the general public think that dementia is part of normal ageing.

Dr Sarah White: And it’s really not, is it? I mean, it is absolutely a disease or collection of symptoms caused by diseases, yes?

Dr Marita Long: Absolutely. And, alarmingly, 65% of healthcare workers also think dementia is part of normal ageing. So there’s a real lack of understanding about what dementia is.

Dr Sarah White: So let me demonstrate my own ignorance here, Marita. Why shouldn’t I be scared of dementia?

Dr Marita Long: I think having that fear is, or that worry, in some ways, can be a positive driver in terms of it might motivate people to pay attention now to how to protect the risk of developing dementia. We know that dementia, the symptoms, present in later years, so after the age of 65 generally, but we know the pathology starts in our midlife. So having a little bit of worry is probably a healthy thing.

Dr Sarah White: So when you say pathology, let me break that down. Pathology starts in midlife. That actually means those changes in the brain that then could lead to dementia if you don’t perhaps do something about it.

Dr Marita Long: Absolutely.

Dr Sarah White: Start in midlife. Right. Just making sure I understand.

Dr Marita Long: So a little bit of worry is a good thing, because, yeah, it might motivate people to go, ‘Right, I’ve got to take this seriously and I’ve got to do something about it’, just like we do with our heart health and our bone health, all those other things. So the fear I think partly is lack of understanding. I think the fear is also being driven by there not being any available curative treatments. But the good news there is that we do know that there is a lot we can do to help slow down the progression of the disease, support people living with dementia with a better quality of life, but it really does rely on a timely diagnosis.

Dr Sarah White: I see. Okay. So when you say curative treatments, that in layman’s language, that means there’s no cure for dementia. We can’t stop it, reverse it, turn it around. But if we get a diagnosis soon enough, there are treatments available that slow it. Have I got that right?

Dr Marita Long: Absolutely.

Dr Sarah White: Okay. And so that timely diagnosis, where do we go for that timely diagnosis?

Dr Marita Long: So that’s really important. So I think if anyone has any worry about their own or someone else’s cognition, that contacting Dementia Australia is a really good first port of call. They have a 24 hour national helpline with trained health professionals who can listen to someone’s story or concern and can guide them about where to go for that next step.

Dr Sarah White: Oh, that’s fantastic. Now we also know, on the basis of that, too, that women are more at risk of developing dementia. Do we know why?

Dr Marita Long: I think that still remains the million dollar question.

Dr Sarah White: I think that’s the second million dollar question we’ve discussed.

Dr Marita Long: Probably. I mean, women do live longer than men, a little bit longer than men, but that’s really not enough to explain the increased number of cases. Look, it might be that, if we’re looking at the current older population and we think about roles of men and women, men were more likely to get access to a higher level of education. They’re probably more likely to be in a cognitively stimulating job. And they probably also had things like their vascular risk factors more aggressively addressed. So we know that heart attacks happen in men, we don’t think about it so much in women. So in some ways, men have had a chance to get a better cognitive reserve and a better brain reserve. So hence we actually are seeing a decrease in the number of men being diagnosed with dementia.

Dr Sarah White: Well that’s good news. So as we start to get a little bit more serious about women’s heart health, and an understanding and recognition that women do have heart attacks and they do look different from men’s heart attacks and we need to pay attention, we might actually start to see those, the number of cases of dementia go down as well.

Dr Marita Long: Yeah, because we will be finding those vascular risk factors.

Dr Sarah White: It really does come back to those good healthy life choices at every age.

Dr Marita Long: And I guess the message there is that we have to think about it on every level. So for some people, the lifestyle factors, or the choices, can be really difficult. So it has to not just rest on the individual, it has to rest on the healthcare professional, also, giving people the correct information. And also we have to turn to our governments to really support those better lifestyle choices.

Dr Sarah White: Yeah, that’s a whole other podcast, how we create an environment that really helps us live very healthy lives. But I’ll go back again. Dementia Australia are doing some fantastic work around their 24/7 or, is it 24/7 call line?

Dr Marita Long: Yep.

Dr Sarah White: That is extraordinary. Are they also doing health professional education? Like if I go to my regular GP, will she know the dementia risk factors, or is this a case of having to arm yourself with a little bit of knowledge before you head into see the GP?

Dr Marita Long: Yeah, I think, like a lot of things, the poor old GP has to know a lot about a lot of conditions, and sometimes it may not be something that they’re particularly au fait with. And that’s why having a podcast and getting out to as many people as we can, to let people know that there are things that you can do, that you can go along and see your GP about.

Dr Sarah White: Yeah, great. And I certainly do not want to be bashing up GPs because they do have to be across a lot. Alright. So if there was one thing you wanted all women to do to take care of their memory and brain health, I feel like one thing is going to not be enough, but if it was just one thing, what would that be, Dr Marita Long?

Dr Marita Long: Exercise.

Dr Sarah White: Exercise would be the one thing? Great. That’s that physical activity again.

Dr Marita Long: I think so. And doing it in a group setting, I think, is a great way to do it as well, because of that added benefit of social connection. Physical activity also improves your mental health. And we know that depression is a big risk factor for dementia. So if people are out socially engaged and, be it in the sunshine, with a group of people, their mental health is also going to be better. So that would be my big take home.

Dr Sarah White: Thank you very much for coming to talk with us, Dr Marita Long, and I am now going to go and do some walking around the block.

Dr Marita Long: Great.

End of transcript

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Staying confident as you age

Dr Sarah White: I am here with Kellie-Ann Jolly, who is the Head of Partnerships and Engagement at Jean Hailes for Women’s Health. Thank you so much for joining us, Kellie.

Kellie-Ann Jolly: Thank you for having me.

Dr Sarah White: Now, you have been the CEO of an organisation, you’re a health professional, you have chaired, or you chair several organisations and boards and things like that. So we wanted to talk to you about confidence, because we know that confidence is really important as we age, particularly in healthcare. So why are we talking about this topic? Why is confidence important?

Kellie-Ann Jolly: I think everyone’s different, but sometimes, particularly as you get older, a lot of things are going through, it’s a transition period. You might be retiring, your kids might be getting older and moving off into, perhaps don’t need you as much. You might be thinking through, ‘What’s next in my life?’ You might be grieving for loved ones or friends. So it is a real transition period, and sometimes we can start to lose our self-worth and start to lose our confidence a little bit. So it’s really important that we continue to think about this, because we always want to be able to have that sense of control and be able to be heard. And I think this is a really important time to think about it.

Dr Sarah White: And I’ve heard you talk about confidence as being something that’s important to make sure that our own needs are met. Is that what you mean in terms of looking after yourself, or something like that?

Kellie-Ann Jolly: Yeah, it is, because, and I think as we age too, we realise that the only one who’s really going to be advocating for us is us, and we actually know more about ourselves than others. So it’s really important that we continue to think about this and to be able to communicate what we want, what we need, and to be able to ask questions, essentially, so that we are able to continue to live and to be healthy as we get older.

Dr Sarah White: Now, some people are naturally more confident than others, and I’ve seen you in front of, speaking in front of very big crowds. I’ve seen you literally at the Gala Balls and things speaking to crowds, and, are you a naturally confident person?

Kellie-Ann Jolly: No, I’m actually not. I’m not a naturally confident person.

Dr Sarah White: Which is actually really surprising.

Kellie-Ann Jolly: I’m very much of the ‘you fake it until you make it’ type. I think with confidence there are some people who are naturally confident, and always have been, and others that aren’t, and you don’t have to always feel confident to act confidently. So sometimes it’s about body language, sometimes it’s about breathing. Sometimes it’s just about being prepared, and you might need to just think things through beforehand to be organised and prepared, that might help you feel a bit more confident.

Dr Sarah White: So share your tips for acting more confident.

Kellie-Ann Jolly: Just more broadly?

Dr Sarah White: Yeah.

Kellie-Ann Jolly: Being prepared and planning. Whatever it is that I’m going to do, whether it’s presenting at a conference, whether it’s talking at a meeting, just being able to think through beforehand what it is that you want to say, how clearly you can articulate and communicate that. So I think that’s something that I do. The other thing is just to breathe beforehand, and just breathe, and think about body language, because often body language can give you away. So if you’re slumping, if you’re apologising before you say something and say, ‘I’m sorry, but—’

Dr Sarah White: We’re all guilty of that sometimes, I know that’s a habit I had to get myself out of. We tend to do it as women sometimes, don’t we? We start our sentences with, ‘Oh sorry, but—’

Kellie-Ann Jolly: Absolutely, all the time. And so you really have to be careful that you’re not saying that, because you shouldn’t be apologising for the fact you’re saying something. And you really do see this, I think, more in the healthcare space, too. Often we feel that we are taking up too much time of our doctor or our health professional, we kind of apologise for the fact we’re even asking questions of them. So I think that’s one thing that we really do need to be aware of.

Dr Sarah White: So these are really great tips. If you’re going into the doctor, you are worried or you’ve had an experience before that you might be dismissed, and I think, sadly, for older women, that is often an experience that they have. So you are preparing for the consultation, taking notes if you need to so that you really stick on track to what you want to ask them about. You are communicating very confidently, even if you don’t feel confident, you’re saying, ‘This is the issue.’ Your body language, got your power stance, shoulders back.

Kellie-Ann Jolly: Chin up.

Dr Sarah White: Chin up.

Kellie-Ann Jolly: And making eye contact is really important

Dr Sarah White: Right, and you’re not apologising, you are there to get the services you’re paying for, right?

Kellie-Ann Jolly: Absolutely spot on. And I think with the preparation, particularly when you’re going to, if we’re talking about doctors or a health professional, really beforehand, thinking through, well, what is it that I really want to come out with here? What are the questions I really need answered? And just put them all down on a bit of paper, or whatever way, it doesn’t matter if it’s on your phone, on a paper, whatever way works for you. Go in with that, because sometimes we, well, most of us will forget. We get in there and we come out and we think, ‘I should have asked that question.’ Put it down as your cheat sheet, have it all there, and be able to, again, particularly with a GP, is to be able to talk about your own experiences, your own feelings, what you’re experiencing, what you’re feeling. Because that’s something, the GP can’t know what you are feeling and what you’re experiencing if you’re not able to communicate that.
So the more that you can take that in and be prepared, even if you read it, whatever works. Have a few little phrases up your sleeve that you can sort of say, ‘Look, I don’t understand.’ If they’re giving you information, ‘I don’t understand that. Can you please explain that in another way?’ I had this example just the other week where I was at a specialist, and, very kind, he was giving me all the information in a very fast pace and in a very complex way about medication. I need to take it this much, on this day, every two weeks I need to change it, and I was just totally lost. So I had to say, ‘Can you please slow down? I didn’t get all that. Can you write it down for me? And is there any information you can give me to take away that I can have?’ So those sorts of things.

Dr Sarah White: Now, a lot of people, though, feel uncomfortable saying that to a doctor, or to anyone, but certainly there’s that power balance thing when you go and see a doctor. No matter how lovely your doctor is, there can often feel like that power imbalance. So how do you overcome that in your mind? How did you go, ‘No, that’s it. Just pause.’

Kellie-Ann Jolly: I think because for me, and I know it can be different for many people, particularly those who are perhaps having some issues with English, potentially, are new to the country, don’t understand the system and not feeling confident and comfortable to be able to do that. And that’s where perhaps a support person or someone you trust, you can take with you, who might be able to help you, not only with language, but also be able to listen to what’s being said, and you can then discuss that with the person afterwards. Because often just going in yourself, you can’t take it all in if you’re not writing it down. It’s sometimes great to have a support person. But how do you do that? I think it’s just constantly coming back to, I want to be able to stay healthy, I want to be able to get a result here. How am I going to be able to do that if I don’t understand, myself?
So just constantly keep asking those questions. It’s supposed to be a team here. The relationship should be a team, not one and the other. So I think, continually, and the more you, I think confidence gains the more you do it. So even if you can just put it out there, courageous, have that courageous one question, and then realise, okay, that wasn’t too hard.

Dr Sarah White: So what do you mean by a courageous one question?

Kellie-Ann Jolly: Well for instance, if you are being talked at or you are being told things—

Dr Sarah White: Lectured to.

Kellie-Ann Jolly: Lectured to is a very good way of putting it. If you’re being lectured to or talked at about something and you’re thinking, ‘Oh, I really don’t, I need to say something.’ Just one question, even if you’ve got it written down, and you say, ‘Help me understand this better. Can you help me to understand this better? Can you tell me this another way cos I don’t understand it?’ Whatever that one question is that you feel comfortable or that you think you can ask, if you can ask that one, and then you recognise it’s not too hard, and it’s okay, I didn’t get the sort of funny backlash that I thought I might’ve got, or disregard.

Dr Sarah White: Cos in reality, you won’t get a backlash, right? I mean, you can be worried about offending, but actually doctors, they’re there because they’re wanting to help people.

Kellie-Ann Jolly: Exactly right.

Dr Sarah White: And they’re not going to get angry. And if they do—

Kellie-Ann Jolly: And they’re human and, you’re right, and they want to help. I think it’s very hard for a GP to second guess if we are not able to ask those questions. So I think we both have to work together in that way.

Dr Sarah White: And certainly the buzzword, probably a bad way of saying it, certainly a key word that’s always discussed is that sort of ‘shared decision making’. And that’s, I think keeping in mind when you go to see the doctor, right? We’re actually supposed to be sharing the decision making, the doctor’s giving me information on the medicine if you like. I’m giving information on my situation and how things are affecting me, and together we come to a decision or a discussion.

Kellie-Ann Jolly: Yeah, just like you might be having a conversation with a friend or somebody else. If you treat it that way, it’s a very similar kind of relationship. It should be a relationship. So yeah, I absolutely agree with that. I mean I think it’s with, yeah, because we do want to be able to come out feeling like we’ve been heard, we’ve been listened to, and informed enough. The other thing, of course, we are also considering what’s being said to us, and whether it’s a diagnosis or tests or medication, in the context of something that’s a lot bigger in our life. So we should be asking things like, ‘Well, how much is this going to cost?’ ‘Is there a priority here?’ ‘How urgent is these tests?’ ‘Can I do this one at a time or do I have to have them all done together?’

Dr Sarah White: That’s really good advice actually, because often I think a healthcare professional says, ‘Right, well, here’s the list of things that you need to get’, but if you actually cannot afford to get them all done at once, or you can’t even, just, you don’t have the time to travel to go and get them all at once, asking for that, that’s a really great tip. I hadn’t thought of doing that myself.

Kellie-Ann Jolly: Because you are living within a context of, a social context, and a financial context that you need to be able to ask that. So it’s not just, and no way the GP is going to know that. So unless you ask those sort of questions, that might help you to then go, ‘Okay, I can do this, I can do that later, and that’s okay. It’s not going to compromise.’

Dr Sarah White: ‘This is the important thing I need to do now, and the other.’ Okay. And so that suggests, too, that having a doctor that you’re comfortable disclosing some of that context is important, but also the time. Now, time with the doctor is tricky. Should we be booking those longer appointments even though they cost a bit more? Should we be booking those so that we can provide that context as we need to?

Kellie-Ann Jolly: Yeah, and I think that’s part of the preparation or the thinking through beforehand. Because once you start to look at, ‘Oh my gosh, I want to know that, I want to know that, want to know all these things’, think, ‘Oh yes, I really do need a longer consultation.’ Recognising that that may be prohibitive for some, there’s a cost, as you had said, there might be an opportunity to look at bulk billing in some cases. But if we can do that, then it takes the stress out of the short consultation and trying to get those things done, from both sides, I think, from the GP and from yourself.

Dr Sarah White: Yeah, sure. That’s been really helpful in terms of diving into healthcare, because I know that’s a bit of a passion and a lot of what you do. What about confidence in terms of changing as we get older? Does it change? And is it always going, is it less? Is it more?

Kellie-Ann Jolly: I think it’s different for different people. For me personally, I feel I have got more confident as I’ve got older, or whether I’m just better at portraying that I am.

Dr Sarah White: You’ve faked it so much, you’ve actually made it, Kellie.

Kellie-Ann Jolly: I actually believe I am. But I think it’s looking at those things that are going to help you, as you age, feel that you have got some self-worth. And looking at your attributes, and looking at the things that you do well, and thinking, ‘Okay, this is who I am and this is what I can do.’ So sometimes you might be letting go of some things that have helped you just to keep very confident, feel confident in your life. You need to look at some new things in your life. So whether it’s keeping active, keeping connected, trying out new things, so all those sorts of things.

Dr Sarah White: That’s tricky, for example, for a lot of women when they retire.

Kellie-Ann Jolly: It is.

Dr Sarah White: Or, as I think you mentioned earlier, when children leave home, perhaps.

Kellie-Ann Jolly: Yeah.

Dr Sarah White: Your Identity does change, so you have to reconsider your identity.

Kellie-Ann Jolly: You do. Yeah. And that’s why, I think I mentioned, it’s a transition. I didn’t say ‘transformation’. For some, it may be, but it is a little bit of a transition in your life. So you might need to just think about, ‘Okay, well what are the other things that I always wanted to do,’ if you can, ‘that I can start to do now?’ Keep connected with others as much as you can. Get out there and—

Dr Sarah White: And that presumably helps build your confidence again, right? You’ve got that social group around you who are your cheerleaders.

Kellie-Ann Jolly: Yeah, yeah, exactly. And I think for me personally too, if I feel physically strong, I feel more mentally strong and more confident too. So I think sometimes, again, it is different. Find the thing for you, there’s a range of different things. And it’s going to take time, but I think that it’s really important, and there is still a level of ageism around, so I think it’s even more important for women, particularly, to continue to be able to feel that they’re contributing, that they’re being listened to, that they’re being heard, and that they have a voice and they can continue to contribute.

Dr Sarah White: And we can certainly start small with some of the things that we do to build that confidence, so that we’re very prepared.

Kellie-Ann Jolly: Yes, and I mean even, I was just reflecting the other day when we were talking about, if you’re not feeling as confident going to your GP, for instance, and saying things. Try it when you go to the shops, and you’ve got a salesperson who’s speaking at you about ‘you must have that new whatever it is, and you must have it because it looks wonderful on you’ or whatever, push, push, push, push, push. And then you, a moment of lack of confidence to actually speak up, you go, ‘Okay.’ You take it, you walk out the door and you think, ‘Why did I do that? I didn’t really need that.’ So I think that some of those, but you wanted to say no, but you didn’t, on that very, so—

Dr Sarah White: You have to practise a little.

Kellie-Ann Jolly: You’ve got to practise a little bit. With the tradesman, the plumber who comes to the house, who wants to do XYZ, and you’re going, ‘I don’t want XYZ, but I’m going to have it anyway, I haven’t said anything.’ So there’s ways you can start to practise that and then you get better at it.

Dr Sarah White: Kellie, do you think women find it more difficult to be confident when they’re advocating for themselves, rather than maybe an elderly parent or a partner or a child? It sometimes feels like if it’s someone else you’re talking about, you can actually be a much stronger advocate for them. Do you think we, sometimes as women, because we’re stepping back a little bit, we could perhaps pretend we are advocating for someone else, but it’s really for us? Does that make sense?

Kellie-Ann Jolly: Yes. And I think that’s a really good way of looking at it, because I absolutely agree. I think all, pretty much throughout women’s lives, they’re always thinking about other people. They’re always caring about other people, they’re very heavily invested, whether it’s their parents, their kids, or whether it’s friends or their partners. So they are always doing that. And so it’s really hard then to be able to then think, ‘Put yourself first’, and to be advocating for yourself. I think that that is a really good idea, to actually almost play the part of someone, and I’m ‘whoever’, and I’m advocating on behalf of them, and not think about it as yourself. It might be a really good strategy to give you the confidence to be able to do that, because I think that most women would definitely be out there advocating for or asking questions if it relates to their children, or their partner, or their parents, if they’re looking after. And that’s what women do, all those areas. So yeah, great tip.

Dr Sarah White: Kellie-Ann, if you had one tip for women as they get older that’s going to help them build their confidence, what would it be?

Kellie-Ann Jolly: I think the importance of the kind of conversation you have with yourself. So it’s a bit of self-talk, for want of a better term. So before you approach something or a situation or an event, or if you’re about to go into your GP, it’s what you’re telling yourself beforehand. So start to be more positive about the whole piece. So talk about, ‘Okay, you can do this, you can do this, it’s easy.’ So it’s that constant.

Dr Sarah White: ‘You’re prepared, you planned.’

Kellie-Ann Jolly: Yes, ‘I’m prepared, I’m planned. What is there to be—’

Dr Sarah White: ‘I know exactly what I’m asking.’

Kellie-Ann Jolly: All of that. ‘I can do this. I’m okay.’ So I think it’s, because often we do the opposite. We are going, ‘Oh my gosh, if I go in there, what are they going to think if I ask all these questions, I’m going to take up their time, they’re going to think I’m silly.’

Dr Sarah White: ‘They’re going to think I don’t know what I’m asking about.’

Kellie-Ann Jolly: All of that. ‘I’m being difficult.’ Whatever. Whatever the situation is, we immediately go to that. And I think women do that far more.

Dr Sarah White: And we do that across all aspects of life, really, too often, don’t we? I mean, I know, in terms of self-talk, I absolutely use that professionally too. ‘Okay, you got this, it’s okay, go for it’ kind of thing. That’s what we have to take as we age because we’re getting a lot of negative, I guess, things coming at us too. Or when you look at popular culture and how it represents older women, it’s not always flattering. So that self-talk is helping to minimise the external environment to some extent.

Kellie-Ann Jolly: Yeah, and I think it just also just helps you to be in the right kind of mindset as you approach the situation. Because if you go into the situation in that negative or you’re thinking negatively about it all, all the things, all the deficits about what might that person think of you, what you are yourself, immediately you’re not walking into a, with a confident attitude.

Dr Sarah White: You’re actually undermining your own confidence, right?

Kellie-Ann Jolly: Undermining your own confidence. You walk in, probably not even realising it, a little bit slouched, a little bit looking down. You’re not necessarily eye contact. So all those things then are all linked. So the more you can have that sort of self-talk, and you just do it to yourself, you can do it in the mirror if you want, whatever works for you. That just, I think the whole experience then is going to be more positive.

Dr Sarah White: Alright, Kellie, thank you so much for your insights as Head of Partnerships and Engagement at Jean Hailes for Women’s Health, and for an incredible, kind of, time and career that you’ve experienced. And I can’t believe that you’ve faked it til you’ve made it because you made it, lady. Thank you.

Kellie-Ann Jolly: Thank you very much, Sarah.

End of transcript

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Emotional wellbeing and social connection

Dr Sarah White: Dr Tessa King, specialist GP with Jean Hailes for Women’s Health, thank you so much for joining us today. And we are going to talk about healthy ageing, so I’m really interested in your perspective on a few things here.

Dr Tessa King: Thanks so much for having me. So great to be here.

Dr Sarah White: Excellent. Now, I know you have a special interest in mental health, which is why we have you here today. And when we’re talking about healthy ageing, mental health is often what we perhaps don’t worry about, but should.

Dr Tessa King: Yeah, I think so. I mean, mental health I think is crucial. It’s crucial to how we feel inside. It’s crucial to how we interact with others. It’s part of our, I guess, motivation to do other things. It really informs our everyday life as well as impacts our physical health. So I think it is really key as we age to have great mental health.

Dr Sarah White: Now, one of the key things around mental health is staying connected as you age. Is that really just a nice to have, or is it something that’s actually really important?

Dr Tessa King: It’s definitely nice to have, but it’s also really important to our health. I mean, we are designed to be social creatures. Our brain has developed and evolved to be social, and it is so complex, because we are social and we exist in a society, in families and in relationship with others. So we are really designed to be social creatures. And if we’re not, if we are not connected and not having meaningful relationships with others, and feeling lonely and isolated, it does impact our health. So not only our mental health, so, in people who don’t feel connected, they have higher rates of depression and anxiety.

Dr Sarah White: Totally makes sense.

Dr Tessa King: Yeah, exactly. And also our physical health. So in people who don’t feel connected and feel lonely, then there’s higher rates of cardiovascular disease, high rates of obesity, less mobility, and also higher rates of cognitive decline. So it actually has a significant impact on our mental and physical health. And in fact, it is the key part to our happiness. So the Harvard study, which was done over 80 years, multiple generations, found that having good quality relationships and feeling connected with others is really the key to our happiness and wellbeing. And it’s not just about going to things, having this X number of friends, it doesn’t really matter the number of friends we have, it’s about that we feel connected, that we feel understood, that we feel that we can reach out to others, and that we have good connections, good relationships.

Dr Sarah White: And so the connections help, so is it a case of the connections help the mental and emotional health, and that means that you do more, you move more, you talk more, is it sort of that connection between mental, emotional and physical? It’s about being stimulated to do things?

Dr Tessa King: Yeah, I think there’s a sort of complex interplay and also what affects others. If we do have poor mental health, we don’t feel like going out, so then we feel lonely, or we don’t feel like we have good quality relationships and we don’t want to go out. So there’s kind of interplay between that. And also if we’re talking more and we’re out and about, we’re feeling good and we want to go out and about, then we’re using our brains, so we have lower rates of cognitive decline. And if we are connected with others and we want to socialise and go and play tennis, go to the gym, go for a walk, we’re going to have better cardiovascular health. So they’re all sort of interrelated, because we don’t just do things in isolation, we do things with others, and we talk, communicate, use our brains with others, and we exercise and get out and about and get active with others.

Dr Sarah White: That makes complete sense.

Dr Tessa King: So with connection to people being so important, what are the top tips that you will use when you’re talking with your patients, for example, about staying connected, particularly as we get older?

Dr Sarah White: I think, doing things that you really enjoy, doing things you love. And that applies to exercise and activity. I always tell my patients, don’t do something you’re not going to keep doing, because it’s pointless. Go and find activity that you like. Walking with a friend, joining a gym if you like that, doing a class, doing a dance class, anything at all. Tai Chi. Something that keeps you active that you enjoy. And then the other thing is doing study. There’s University of the Third Age, so you can study—

Dr Tessa King: Online, for example.

Dr Sarah White: Yeah, short courses. There’s a lot of stuff in person as well with University of the Third Age. So studying something, a language or a subject that you really want to know about, study is one way to stay connected. Joining clubs, organisations, and staying active. Volunteering, there’s Volunteering Victoria, you can have a look, whether you want to volunteer at a hospital, club, organisation. Yeah, volunteer work is a great idea.
That’s actually a really great idea for women who are living rurally and regionally, right? Because where there might not be as many options for Tai Chi or tennis or something like that, volunteering, I think, has been shown to be really beneficial.

Dr Tessa King: Yeah, I mean, I think we need purpose, and feeling needed and contributing to society, and it’s not about paid work, it’s about having purpose and contributing in some meaningful way to others. And there’s lots of great opportunities, whether it’s cooking food for others, whether it’s mentoring. There’s also, I know that hospitals sometimes have older women that go and just cuddle the babies, which I really want to sign up for. Need baby cuddle!

Dr Sarah White: We need you back in the clinics for a while yet.

Dr Tessa King: But yeah, lots of opportunities just to stay purposeful and connected. And the other thing, like we always say, do what you love, et cetera. And as you get older, you might not be locked in by paid work, but also you don’t have to love every moment of everything. When we go to work, we don’t love every moment.

Dr Sarah White: No?

Dr Tessa King: I don’t know about you. But we go there and we get a lot of interaction. We get purpose, we feel confident at the end of the day. And the other thing is, when you’re older, you can get a casual job if you want. Work in retail, something really low stress or something, there’s the option of getting a job as a way to stay connected as well. And also doing things sometimes that we don’t love as well.

Dr Sarah White: Right. And so having that purpose, is that one of the common challenges that affects mental health and emotional health as we get older?

Dr Tessa King: Yeah, I think having purpose and also making meaningful contributions to others, whether that’s in relationship or actually doing tasks for others, we feel a lot better about ourselves if we get asked to do something, like asked for help, versus if we’re asking for help. So actually doing things to help others improves our mental wellbeing and our happiness hugely. So that contributing to others in some way, it doesn’t have to be formal volunteering, you could babysit the neighbour’s kids or your grandkids or bring a meal over when someone’s sick. Just little things that you feel like you’re making a meaningful contribution to others.

Dr Sarah White: Yeah, fantastic. And what are the other things that tend to affect emotional health, do you find, with your patients as they get older?

Dr Tessa King: So I guess, lots of things. So, physical health. So, decline in physical health can definitely massively affect mental health. So, major illnesses, but also just general normal decline that occurs as we get older can impact people’s mental health. Just being frustrated they don’t have the same level of energy, they can’t do the same things that they used to be able to do physically. So that can really impact how people feel about themselves. The other thing is loss of friends, family, spouses. So as we get older, we lose more people and that can impact us hugely.
Also, menopause and the change in hormones can be a huge impact on someone’s mental health. And that can be around perimenopause and menopause, but also can continue to impact cognition and mental health as women get older and are further away from menopause. How we feel about our sexuality as we age, how we feel about our own bodies, that sort of thing.

Dr Sarah White: So there’s a lot of, I guess, that change can introduce a lot of challenges when it comes to emotional health. Is there a case for really exploring how to build resilience and that positive outlook? Is that part of the connection piece as well?

Dr Tessa King: Yeah, I think so. And I guess, building resilience to change, I mean, I think acceptance around change, but also some level of grit and determination to continue to be able to do the things that you want to do, or build strength, or learn a new skill. I have women in my gym in their fifties, sixties, seventies, and a woman who’s 70 who’s got her first pull-up, that took her two years to get.

Dr Sarah White: Oh, amazing. I can’t do a pull-up.

Dr Tessa King: Well, yeah!

Dr Sarah White: Maybe when I’m 70.

Dr Tessa King: And it’s something she always wanted to do. And now she had the time and dedicated, very slowly. And I’m sure had she done the training at 30, it probably would’ve happened in a year, but at 70 her body took time to adapt to that and she got it. And people, you can do new things if you are determined and there’s a goal that you’ve got in mind. So yeah, some level of acceptance, but also a bit of grit and determination and fight to be able to keep doing the things that you want to do.

Dr Sarah White: Do you have patients sometimes who feel it’s a little bit inevitable that they’re going to go into this decline and so there’s no point anymore? Do you have patients like that and what do you say to them?

Dr Tessa King: Yeah, sometimes. I think a lot of my patients probably very proactive. They’re coming to see me because they want to feel better. They want better quality of life, rather than it being inevitable. Maybe those are the ones who aren’t coming to see us, who are accepting things. But then I do definitely have patients who’ve come to see us, had a really great outcome and change in their life, and then their friends have come.

Dr Sarah White: I love that.

Dr Tessa King: And they’re like, ‘Oh, I’ve seen the difference with my friend Judy, and I really want to feel better.’ If you’re not feeling like yourself, really finding a good health professional that can help you have better quality of life, that doesn’t just tell you that’s the way you’re supposed to feel.

Dr Sarah White: You’re at a certain age. This is just—

Dr Tessa King: Yeah, there’s lots of things we can do to help you. It’s not always medication. It might be something else.

Dr Sarah White: So if I go back to ways to take care of that emotional health. Are there just some really key simple things that we should all be doing, no matter our age, but become particularly important as you get older?

Dr Tessa King: Yeah, I think, I mean, meditation and mindfulness have been shown in big studies to really help. And I always tell my patients, everyone is bad at it. You don’t need to be good at it.

Dr Sarah White: Guilty as charged!

Dr Tessa King: I say, you can daydream as much as you want. The goal is to just do it and do it to the best of your ability. I don’t care if you’re terrible at it. It’s sort of like, yeah, if you are terrible at tennis and you never play tennis, you’re never going to get better. But if you do some lessons, you’ll probably get a bit better. So same thing with mindfulness, our brains will get a bit better.

Dr Sarah White: And mindfulness is really just focusing on the here and the now and just taking that time to experience here, now, everything, not thinking forward, not thinking back just being in the moment.

Dr Tessa King: Just being present, but also, I guess, allowing some level of ability to watch our own thoughts and not necessarily buy into our own thoughts, and watch them, I guess, ‘detach’ feels like the wrong word, but in almost a—

Dr Sarah White: Like an observer point of view.

Dr Tessa King: Yeah, observer point of view, to see sometimes there’s a whole bunch of negative thoughts that our brain just throws up, and being able to just observe them rather than go down and spiral down with them. So that’s another benefit. And then I often get my patients to do mindful self-compassion. So that brings a compassionate awareness. So you’re not just paying attention to the present, you’re doing it with self-compassion and self-kindness.

Dr Sarah White: Right.

Dr Tessa King: Yeah.

Dr Sarah White: Now I imagine it’s things like sleep. Sleep is something that comes up a lot.

Dr Tessa King: Yes.

Dr Sarah White: That’s something that you’re asked about. And what do you say, if you have someone who’s coming to you and saying, ‘I’m really struggling with my sleep’?

Dr Tessa King: So the first thing I say is, I ask them, is it trouble falling asleep versus waking up? But in terms of the normal sleep, people sort of expect, I’m going to go to sleep, then sleep for eight hours, and then wake up. And that really isn’t the norm for most adults. Most adults tend to be okay at falling asleep. And that isn’t a huge problem for most adults. A lot of adults will wake up somewhere between 1:00 and 4:00 AM, and they wake up and then—

Dr Sarah White: Also guilty as charged.

Dr Tessa King: Yeah. And then they wake up, and depending on how much sleep you’ve had, if you’ve only had two or three hours, it might be half an hour, an hour, for you to build up enough sleep deficit for your body to be able to go back to sleep. But if you’ve already had four or five hours, it may be another two hours of being awake before your body has built up enough sleep deficit to go back to sleep. And that’s normal. But allowing that, that’s a long time, if you’re wanting to get seven hours you’ve got to be in bed for nine and a half hours.
So just talking to them about the norm, sometimes that’s enough. But sometimes people, it might be night sweats that are waking them up, in which case we address that. It could be stress, that they wake up and then their mind is just ruminating, so obviously addressing that. Or it could really be significant insomnia. And then we obviously address that with sleep training, sleep psychologists, sometimes medication.

Dr Sarah White: Right. Now, going back to mental health, how do we know if we actually need that extra support, or we need to talk to our doctor if we’re struggling? At what point do we say, I’ve tried a few different things, I’m trying my mindfulness, I’m trying to get my sleep better, I’m moving, I’m physically active, I’ve got that social connection. What point do I say, right, this is where I need some support?

Dr Tessa King: So that’s a really difficult question because often we get adjusted to a new baseline. So sometimes mental health can be poor for a long time, and we just assume that’s normal and there’s nothing we can do about it. So I guess it’s trying to work out, are we really feeling good? Are we enjoying things? And if there’s been huge life stresses, someone’s lost a job, moved house, lost a spouse, it’s normal for them to have mental health difficulties, difficulties sleeping, feeling low, feeling teary, because there’s stuff going on externally.
But like you said, if everything’s going well, but you’re just not feeling right, you’re not enjoying things.

Dr Sarah White: So you’re not enjoying things.

Dr Tessa King: You feel sad, you feel very anxious sometimes, physical symptoms of anxiety. If you just don’t feel like going out, you don’t feel like you’re really connecting with others. You feel irritable, cranky, grumpy all the time. You’re just not feeling like yourself. And again, it might have been a long time since you felt like yourself, which doesn’t mean you can’t feel like yourself again.

Dr Sarah White: Okay, sure.

Dr Tessa King: But for some women, especially through menopause, can be, it’s been so long since I felt like my old self, and often can kind of give up. But yeah, I’d encourage people to speak to someone. Even if you’re like, ‘Oh, I’m not really sure.’ It’s always good to have that conversation.

Dr Sarah White: Dr Tessa King, thank you so much for being part of our Healthy Ageing series. It’s been a real pleasure to have you here.

Dr Tessa King: Thanks so much for having me.

End of transcript

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