Not Another Feel-Good List:: Getting Real about Mental Health

One thing I love about awareness weeks and months is that they provide great fodder for {re}starting conversations about critical topics that are often recognized far less frequently than they deserve. But sometimes I want to scream from the rooftops, why aren’t we talking about this issue every single day??? Mental health falls into this category, hands down.

This year, I hope that the slow {safe} emergence from our COVID cocoons helps folks battling isolation, hopelessness, anxiety and depression see something to which they can look forward. But, I also hope that the effort to recreate a pre-COVID life doesn’t allow us, as a society, to un-learn some of the lessons the pandemic has hopefully taught us. The most important one:: crafting a life that prioritizes your mental health is not selfish, weak, or indulgent. Rather, soothing your mind in times of crises big and small is the most important life lesson we all can learn, and teach our children too.

Not Another Feel-Good List:: Getting Real about Mental HealthIn my line of work, I see a few things on the regular:: medical conditions {PCOS, infertility, endometriosis!} that undoubtedly impact mental health, concerns over hormones that may have gone astray, and lots and lots of confusion over how to address all the feels that result. So, as a reproductive endocrinologist {hormones are my jam!}, and a wife and mama who often feels she’s coming up short, here is my mental health wishlist for all of you::

  • Sometimes, it IS your hormones! My medical endocrinologist friends have endless memes about how it {insert non-specific symptom here} is not always your thyroid, but, you know what? Sometimes it is. Fatigue, sluggishness, brain fog, many of the symptoms that make you feel not like yourself, can be due to alterations in a variety of hormones. Thyroid issues are one big cause, but there are many others. Women with polycystic ovary syndrome (PCOS) are 3-5-fold more likely to experience anxiety or depression. Infertility has a massive impact on quality of life, and sometimes on your marriage, which might also rob you of one of your core support people. If you’re not up-to-date on seeing your primary care doc and your gynecologist, start here. A great physician will hear you and offer the appropriate evaluation to make sure there’s not a physical root to your mental health struggles. 
  • Banish any shame around seeking help:: I hope the notion that mental health struggles should be kept a dark, dirty secret is fading away, but I know this dangerous misconception is still out there. Postpartum and early motherhood are extra risky times when it comes to your mental health, but there are so many little things that add up to the life we lead, and any one of these could throw you for a loop one day. An ill parent, a loss in the family, marital strife, workplace dynamics, medical issues, financial stress, a global pandemic {!!} – any of these can surface at any time, and sometimes we need help finding our balance again. White-knuckling it through times of crisis is not my recommendation! Whether it is a group text thread where you can let loose, a support group, a therapist or life coach, start looking for your people. It has taken a lot of introspection and guided work for me in this past year to recognize the unmet needs fueling my moments of malaise, and both time and money invested into myself to work past these areas of vulnerability. Before motherhood, I powered past tough moments by throwing myself into my passion for my work, pounding it out with a hard workout, or escaping into a work conference or girls’ weekend – but now, my kiddo needs me when she needs me, and the old strategies of running away from my feelings definitely don’t work. What has worked:: finding a few specific groups and a life coach who all get me. In other words, find your tribe.
  • Be honest about how you are {or aren’t} nourishing yourself:: Last year I picked up an extra board certification in lifestyle medicine, and studying for the examination left me reflecting on how unequipped traditional medical training and the healthcare system are for helping folks create a lifestyle that promotes physical and mental health. It pains me every time I recommend one of my patients, clearly struggling, to see a mental health colleague, but knowing all the while that electing to do so will add yet another cost to her treatment. More and more insurances are slowly adding mental health benefits, and sometimes even offering coverage for gym costs, acupuncture and more, so make sure you look into – and USE! – the benefits you have. But whether or not you’re engaging in therapy, the science does show that lifestyle can also play into how we feel in a big way. Eating a plant-forward, whole foods based diet {cut out the fast food, junk food, processed food – all that extra sugar and salt is horrible!}, drinking enough water, watching and limiting consumption of alcohol {mommy wine culture is contributing to sharply increasing rates of drinking in young women, a risk factor for breast cancer and other health issues down the line}, tobacco, marijuana, getting enough sleep {7-8 hours when you can}, staying physically active and pursuing active stress management techniques {mindfulness, meditation, social time, acupuncture, exercise} comprise the foundation of Lifestyle Medicine, and each have been shown to benefit mental and physical health.

I’m a big believer in cultivating a positive psychology. I’m not stellar at it in my own life, but I’m learning, and I aspire to what I recommend in the office. Every night while getting ready for bed, spend a minute or two reflecting on the day:: can you think of one or two great things you did for yourself? It could be anything… I spent an hour on the phone with my bestie {or my therapist!}, I drank enough water, I ate so well today, I got a great workout in, I went to yoga or acupuncture, I didn’t drink an extra glass of wine even though I wanted to – hopefully, you get the idea. It could involve candles and bath bombs, but self-care is way more than just that. If you can knock out a few of these things on the daily, I personally am impressed by you, and I want you to be too. Your body, and your mind, thank you.

If you feel you have a loved one struggling, see what you can do to help her regain some control by maybe taking one of these endeavors on together. Ask her to help YOU by joining you at a workout class, or going for a walk, or trying out a new healthy recipe. I’ll close with a challenge:: having read this far, commit now to doing something good for you today, and maybe even every day for a week! It can only make you feel better!

And, always, if you or someone around you is in crisis, know how to seek help.

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Rashmi Kudesia
Rashmi Kudesia, MD MSc is a board-certified OB/GYN and Reproductive Endocrinology & Infertility specialist who is passionate about improving women's access to evidence-based, honest reproductive health information and care. Aside from her clinical practice seeing patients in Houston and Sugar Land, Rashmi frequently speaks at conferences and community events, and advocates for women's health via media interviews and social media. Originally a Midwesterner, she moved around the East Coast for school and training, including nearly a decade in NYC, where she met her husband, Ashish, a Houston native. After moving to Houston in 2018, she's continued searching for that perfect work-life balance as the family grew quickly, adding their first pup, Bowser {2018}, their first home, and now their first kiddo, Amara {2019}! Right now, she's learning the ropes of being a working mama, but still loves exploring Houston's amazing food scene, checking out the newest museum exhibits, or planning the family's next trip. She's always on the hunt for the city's best iced latte or glass of wine to be savored with a good book. Find her on Facebook and Instagram {@rkudesia}.


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