Wellbeing, connection and healthy ageing – podcast

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