What We Get Wrong About Mental Health (Featuring Dr. Mike Banna)

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We have an amazing guest for you today.
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He is not only a doctor for the National Health Service, he is a GP trainer and training program coordinator, meaning he teaches and coordinates education for other doctors.
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He is also the regional director of the British Society of Lifestyle Medicine and has a special interest in mental health and lifestyle change.
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More importantly than all of that, of course, is he is a very, very good friend of ours and is legitimately one of our favorite people on the planet.
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It gives us an amazing pleasure to introduce you to Dr.
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Mike the Second or Michael Banner.
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Thank you very much.
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What a lovely intro.
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And obviously the feeling is mutual.
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Thank you very much for having me.
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I always have to check did we say anything wrong?
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Or did we did we omit any pertinent and important information?
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No, I don't think so.
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No.
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Actually, you know what is important is sure enough where I'm you know what is important is that he loves to rate food out of seven.
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And I feel like we should have intro included that intro intro.
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I'd love to rate everything out of seven.
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Yeah.
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Um yeah.
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I mean, yeah.
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Well it's fine.
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Did I say something wrong?
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What was it?
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No, it's a training program director, not a coordinator.
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And a regional director, not the regional director.
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So it's only I'm just like in a self-deprecating manner, I don't want to be like, I'm not as in, it doesn't matter.
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Like that that's I think it's fine.
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Yeah, it's fine.
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Okay.
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It's fine.
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Thank you for the rewriting slightly.
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He's not actually quite as big a deal as I made him sat.
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That's exactly.
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And I would never want to over big deal myself.
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Today we are going to talk about mental health and physical health.
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Yes.
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But I think as a nice beginning foundation to this episode is I have talked about my own mental health in the past.
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And I have said on social media that a few years ago, prior to us meeting, obviously, that I said, I don't think I'm ever going to be happy.
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And the person I sent that message to was you.
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Yeah.
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And the reason I think that's important is because in this context, I actually didn't know you very well compared to some of my other friends who I had known for over a decade, nearly two decades.
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And I think it is a testament to your personality where you made me feel like I could share that information with you.
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And also maybe that I thought you might have words of wisdom that I didn't trust anyone else with.
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I wouldn't tell my family, I wouldn't tell my closest friends, but for some reason I told you.
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Yeah, I think it's always a really interesting thing when it comes to mental health.
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I think that sometimes, I think sometimes genuinely, and this isn't to do any of that down, but sometimes we do feel more comfortable sharing things with people who don't know us as well.
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Yeah.
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Um, and I think there's a number of reasons for that.
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And it's one of the reasons is the same reason that we recommend that people get professional help in situations where they feel that they need it.
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Because a lot of people will say, Oh, no, I've got friends that I talk to, I've got um family that I talk to.
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But if people are really struggling with their mental health and they talk to a friend or a family member, somebody who loves them and cares deeply for them, they're not gonna get an objective response to the thing that they're talking about because that other person's agenda, quite rightly, isn't just I I want to say the right thing, I want to help them, but that other person in that moment is gonna be feeling a whole bunch of emotions themselves about how you're feeling.
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Your family desperately don't want you to be feeling bad.
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They don't want you to be struggling with your mental health.
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And I think in a lot of situations, you know, you hear stories of people trying to open up to people who care about them and not getting the kind of response that they want or feeling dismissed or something like that.
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And I think, you know, I think when somebody when somebody tells you that something is wrong and you don't want, you rest really desperately don't want there to be something wrong with that person, it's really tempting to kind of just go, oh no, it's fine, that's completely normal.
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Like I feel like that all the time.
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You're doing great.
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Yeah, exactly.
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And and it's not because you don't care or because you want to be dismissive of the issue, it's more that you just desperately don't want this to be the case.
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But when you speak to somebody who is a bit more objective, they can listen to that story without feeling the same emotions, the anxiety that it might bring out in people who care more deeply for us.
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I'm not saying that I didn't care deeply for you in that moment.
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Wow.
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But but I think that it it sometimes just is easier to open up to people who aren't, you know, a really super involved part of your life.
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If I if I did turn around and be really judgmental and deal with that horribly, it wouldn't have mattered because I wasn't part of your close circle at that time.
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So I think that there's something that there's something that makes it sometimes easier to be vulnerable about in front of people whose judgment matters a bit less to you as well.
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I just cared about you less.
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Is actually what actually phenomenal.
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No, I think I think I think part of it is I remember we've talked about this a lot, especially with a daughter and how we want to parent.
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But I remember this is the thing we've talked about, when I was a teenager, for example, and I was going through adolescent life stresses.
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I remember there I wouldn't talk to my mum, for example.
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And part of that was because her reaction felt so strong, yeah, that it made me less inclined to want to share something.
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So it you don't confide in people where you don't trust that you're going to have a compassionate ear.
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Yeah, I think.
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And if there was one way that I would describe you, it would be compassionate.
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I think that is one of your one of your best traits.
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But anyway, before we start all this, what I think a nice way to start would be is why do you think mental health has such a stigma to talk about?
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Well, I think um it's almost like one of those things that is so endemic in the world and in history that is almost difficult to answer.
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It's like saying, why do we need water?
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You know, it is such an entrenched way of thinking that I think society has had.
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I think mental health, or particularly more appropriately, mental illness, has been so heavily stigmatized for centuries.
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You know, people who suffered with mental illness were completely disenfranchised, completely segregated from society, treated terribly in so many ways, and often still are, unfortunately, in many places, that I think it's become such a normal part of life to feel uncomfortable talking about mental health, that it has taken huge amounts of effort from, you know, many sectors, many different people, many groups, to try and get people to talk more openly about mental health and to recognize mental health as we recognize physical health as being a spectrum, as being something that we have to pay attention to regardless of how healthy or unhealthy in that respect we are.
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You know, when we're young and fit and healthy, we still encourage people to exercise and eat well and do all the things that support their physical health.
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But historically, we've been very bad at encouraging people to do the things that support their mental health and mental well-being.
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And when we have talked about needing to support mental health and mental well-being, even that has been seen as a sign of of weakness or softness that, you know, why are you why are you worrying about that?
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Why do you need to protect your mental health?
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And that's kind of embarrassing when you think about it.
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Like we know a we know enough about mental health to know that we do need to support it.
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We know enough about mental health to know that, you know, any of us can be at risk of poor mental health, um, both through our environment, through life events, through things that happen to us, through our genetics, um, and just through circumstance and poor luck.
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Uh we should be focused more on talking about it and being more open about it.
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Um, but I think people also struggle to really recognize and I I think it's hard because I think people don't really want to believe that these things can happen to them.
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Of course, we don't.
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Um So I think often people ignore that side of it because it's easier.
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I wonder too, how much of it is talking about mental health oftentimes involves talking about your feelings, and talking about your feelings can be portrayed as a weak, more feminine.
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Not that I'm saying obviously being feminist is weak or anything like that, but it it requires a level of vulnerability that maybe 80 years ago that was not a thing that you did.
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And I I one one criticism or one pushback that I often hear is that, well, uh, my grandparents are, you know, back in my day, we pulled ourselves up by the bootstraps and we were fine.
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And I'm like, but you're not fine.
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You are not fine.
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And I think that's the part that people don't really acknowledge enough.
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I don't know how much of that is a male-female thing, and I don't necessarily think we have to go down that path.
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But I know there is certainly a a kind of generational belief that if you said you wanted to go to therapy, for example, a lot of people would view that as soft.
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Yeah.
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It's like back in my day, we were going off to war, and you are speaking to someone about your feelings.
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Yeah.
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Yeah.
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I know, and I think it's really interesting because you can also say back to those things back in those people's days, they were going off to war, and now they're scrolling AI videos on Facebook.
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You know, they're not still going to war.
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So you know, times are different.
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And I think that we need to recognize that that's they're dancing to TikTok, exactly, right?
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So I think we have to recognize that times change and cultures change.
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And it is very tempting because we always, I think, in society, look back at times past fondly and think that things were better then.
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Things weren't better then.
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People were at war.
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And of course, people didn't have the privilege or the luxury of going to therapy, but now we do.
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So why do we want to withhold that?
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And it's a conversation I often have with um patients because, of course, like I see all kinds of spectrum, uh, well, the whole spectrum of people's views on things like medication when it comes to mental health.
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So think, let's say, let's use kind of antidepressants as an example.
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And there are still very many people who see taking antidepressant medication as a failure rather than as something that is empowering them to help them get better.
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And so there can some, and of course, I see the opposite as well.
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I see people who want to be on antidepressant medication who might not necessarily need it and everything in between.
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But I often have this question where, you know, people will say something like, Well, do I, do I really, I don't think I need to go on antidepressants?
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And it's a really important discussion to have because I think, you know, over medication is not a good idea.
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We have side effects, we have risks, etc.
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But I also sometimes ask the question to people that if there is something that can help you to feel better and you are currently in a situation where things are objectively quite bad, bad enough for us to be having this conversation in a doctor's office in the first place, then what would be the reason to withhold any sort of treatment that could help, be it therapy, be it self-help, be it, you know, um other forms of you know, counseling, EMDR, those sorts of things or medication?
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Why do we want to withhold any of them?
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But people are very happy to withhold the ones that they view, usually culturally, usually societally, usually through perhaps their parents or their peer group, um, in order to, I guess, not have to admit that there's a problem, perhaps.
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I don't know.
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What is the difference between normal emotions like sadness, stress, anxiety, and uh true mental health disorder?
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That's a very good question.
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And I think one that we don't always get right when discussing it, particularly on in pla like spaces like social media.
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Uh, people often talk about anxiety.
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It's a really, really good example of it because people talk about anxiety.
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Anxiety is an emotion.
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Anxiety disorder is an illness.
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And I think it's really important to differentiate the idea that everybody experiences anxiety.
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The difference between anxiety as an emotion and as and anxiety as a disorder is the impact really that it has on your life and the context in which it happens.
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So, for example, it might be completely normal for me to feel anxious about standing in front of a crowd of a thousand people and delivering a lecture or something like that.
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But it might not be completely normal for me to feel anxious having a coffee with a friend.
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And it's about how anxious those things that shouldn't really make you feel anxious make you feel and the impact that it has on you.
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So, you know, there are plenty of people who might feel a bit anxious about doing things that might not make other people feel anxious, then it might never stop them from doing those things, or it might never have such a significant impact on them that they ever feel that they would need to address it.
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I think people often describe themselves as anxious people and may have a more of a tendency towards anxiety, the emotion.
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But anxiety as a disorder is having a significant impact on your daily life.
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It might be stopping you from going to work, it might be stopping you from socializing with people, it might be stopping you from going out of the house, for example.
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And there are a lot of situations where you can very clearly see that it's abnormal, but there are also big grey areas where it's really difficult to tell.
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And I think that's where a lot of the confusion comes from because there's no blood test for anxiety disorder.
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We diagnose these conditions, and it's the same, you know, with a lot of mental health conditions and a lot of um, you know, neurodiversity and things like that.
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We diagnose them based on reported symptoms, yes, um, discussion, and it's hard to tell sometimes.
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And I think that I'm sure I have no doubt that there are times when we treat people for depression when they perhaps don't have depression, they perhaps are going through a difficult time, um, but it's presenting as depression, uh, or times when we don't pick up that somebody is clinically depressed and we're not treating them as well as we could be.
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So it's they they are difficult conditions to to treat and to diagnose correctly.
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Um, you know, as we see, we see very sad stories in the media all the time about people who people did not realize were struggling with very significant mental illness.
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Yeah.
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Because it isn't always obvious.
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Yeah.
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The the the one example that I think of is high-functioning depression, where they are able to be super productive and show up to work and thrive in all those environments and be a great partner and great parent.
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But inside there's all this turmoil that they're going through that other people may not know about.
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Yeah.
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And I think that's something that I that is, I think, as you were saying at the beginning of the episode, a really big uh a lot of times that's when people can be very dismissive of, but you're smashing it in life.
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What do you mean you're struggling?
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What do you have to be depressed about?
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Yeah.
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Yeah.
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And I find that hard.
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Absolutely.
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There are so many things I want to say.
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I'm trying to pick the most valuable avenue to go down.
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Like when you say, what is there to be stressed about, that is a whole can of worms that I'm not sure if I can touch.
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But as an example, and I'm not making this an episode about me.
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I I dislike the idea that that might be how it comes across.
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But I also know the easiest example I can give is myself without sharing other people's personal stories.
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So when I was talking to you years ago before we were together, I would be someone who described myself as quite a depressed person.
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I wouldn't have said that I had depression as such.
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I didn't have, I didn't take medication, for example.
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I wasn't seeking help.
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And then I reached out to someone, and based on a very early initial chat, you said it's kind of done on how you feel, it's self-reported feelings.
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They said it sounds like I have moderate depression and I didn't get treated.
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This was not that long before we started dating.
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And now I look back since we've been together, I have become the happiest I've ever been.
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And at the time I kind of reflecting on it, it's very hard to untangle whether I was I would describe myself as a depressed person, or if I was in a temporary state of depression, or my life circumstances were making me feel that way.
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Yeah.
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Does that make sense?
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Yeah, 100%.
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And you know, we talk about reactive depression.
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So reactive depression is when a set of life circumstances has led you to feel the symptoms of depression, but it's not necessarily inherent and out with that.
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And if you, you know, and I often I often say in discussion with patients when when talking about these things, if I gave you a magic wand and fixed all of these particular issues that you feel are bringing you down, do you think you would still feel this way?
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And it's not necessarily a, you know, it's not a hard and fast way of diagnosing, but it's an interesting discussion to have because sometimes people will say, No, I I feel I felt like this beforehand, but it's even worse.
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There's lots of different, different avenues and different pathways down which these things happen and unfold.
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And I think again, like it sort of comes back to me sometimes with the idea, and I don't know how perhaps other clinicians would feel about this, but again, if you in that situation were suffering from uh a moderate form of depression because of your circumstances, and you come and see a health professional, that health professional can't bring you the circumstances that may help you feel better, but perhaps they can help you work on how you manage and moderate those emotions while they're making you feel so bad.
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And I think there's value in that anyway, because if perhaps also you can then manage to find a way to feel happiness without having the circumstances be right, I think that that's also something like I think the the issue with things like depression is that it's so multifactorial and there are these psychological aspects and these kind of chemical aspects and um genetic aspects and you know how our brains function and what we respond to, that it can sometimes be quite difficult to know what it is exactly that has helped in some people's situations.
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And sometimes, you know, sometimes people will come and talk to me and we will have a conversation about all of the different things that we can do, and we might say, well, we can try these different things, and they might be unsure about what they want to try.
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And we might say, Let's touch base again in another few weeks, have a think about what you want to do, have a look at these resources, etc.
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And they might come back already feeling so much better because all they really wanted to do or needed to do was to share the issue with somebody, to have somebody validate how they were feeling.
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And even just that consultation can be really helpful.
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Sometimes people will start medication and they will feel so much better way before the time that it takes for the medication to work because they're they know that they're doing something.
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So, you know, even the positivity of understanding or feeling like something is going to help can also make us feel better.
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So it's so multifactorial that, you know, still the argument is, but in the context of the circumstances that that are around you at the moment, how can I, as a clinician, help you to feel better or help you to manage those things better, or help you to be in a better place where you are open to fixing those circumstances yourself?
00:20:11.200 --> 00:20:24.720
Because sometimes when people feel depressed, they don't have the motivation or the ability to actually do the things that they need to do, to find a job, to work on their career, to go to the gym, you know, those sorts of things.
00:20:24.799 --> 00:20:39.759
And that's why I think it's always difficult when things like medication get a bad rap, because sometimes that's the thing that helps people to do the real work that it takes to help manage what's going on.
00:20:40.000 --> 00:20:41.920
And then get them in an upward spiral.
00:20:42.160 --> 00:20:52.640
Because I can see that completely becoming a negative feedback loop where if you're too depressed to do anything that would then help you feel better, that can then make you more depressed and then further leave you in that pit.
00:20:52.960 --> 00:20:53.279
Exactly.
00:20:53.359 --> 00:20:53.599
Yeah.
00:20:53.839 --> 00:20:58.640
So what are some signs that someone is not coping as well as they think they are?
00:20:59.039 --> 00:21:02.319
So I would say this is again very different for different people.
00:21:02.559 --> 00:21:11.200
And I think that I think it's almost I think it's really hard to tell how other people are doing.
00:21:11.359 --> 00:21:11.599
Yeah.
00:21:11.759 --> 00:21:18.559
And I stu I sometimes think that for some people it's really even hard to tell how we are doing ourselves.
00:21:18.799 --> 00:21:24.079
I think it's very easy to tell ourselves that people are fine when we want them to be fine.
00:21:24.240 --> 00:21:24.559
Yes.
00:21:24.799 --> 00:21:39.839
And one of the things that I always struggle with is this idea that that I guess everybody around people should be picking up on these things, should be supporting people, should be doing things to, you know, should be the safe space for people to come and talk to.
00:21:40.000 --> 00:21:43.599
It's a lot of responsibility to put on other people.
00:21:44.160 --> 00:21:49.200
Um and I don't think that there's anything wrong with being that for people.
00:21:49.279 --> 00:21:51.759
I think it's very important to try where we can.
00:21:52.000 --> 00:21:57.680
But I think what it what it kind of excludes from the conversation is how that other person is also feeling.
00:21:57.759 --> 00:21:58.079
Sure.
00:21:58.240 --> 00:21:59.519
We all have our problems.
00:22:00.160 --> 00:22:06.160
Our stresses, um, our life issues, the things that are that are worrying us or making us anxious or bringing us down.
00:22:06.640 --> 00:22:11.759
And sometimes we're in a great place and we have a great capacity to be able to be there for other people.
00:22:12.000 --> 00:22:28.960
But there are also plenty of people who have driven themselves into the ground trying to be the good friend to everybody else, trying to pick people up, trying to make sure that they're, you know, looking out for people, checking in on their friends, and who's checking in on those people?
00:22:29.119 --> 00:22:32.640
And I think that that's a really important thing to remember.
00:22:32.960 --> 00:23:15.920
But having said that, to answer the question, I just think, you know, having honest conversations with people, picking up on little changes in people, you know, if you notice a change in in somebody's behavior, in how they're socializing, in how they are um interacting with people, in how they're how they're sleeping, how they're exercising, how they're taking care of themselves, how they are um showing up at work, um, even sometimes their appearance, things that are changing, things that don't seem quite right, I think if you are in a position to be able to honestly say, and in a non-judgmental way, I notice X.
00:23:16.319 --> 00:23:16.720
Yeah.
00:23:17.039 --> 00:23:17.839
I just wanted to check.
00:23:22.480 --> 00:23:22.720
Yeah.
00:23:22.960 --> 00:23:25.200
Because I think it's really, I think it is really difficult.
00:23:25.279 --> 00:23:26.799
And we're talking about sensitive issues.
00:23:26.880 --> 00:23:35.359
You know, if you notice that somebody is isn't as kind of well groomed as they might normally be, or isn't look doesn't seem to be kind of looking after themselves.
00:23:35.519 --> 00:23:45.839
And I say that that means a whole number of different things, whether it's, you know, hygiene, whether it's um whether they're exercising, whether they've changed in their weight.
00:23:46.000 --> 00:23:46.240
Yeah.
00:23:46.480 --> 00:23:48.880
These are very sensitive issues to bring up with people.
00:23:49.039 --> 00:23:54.160
So if you're not able to bring them up in a sensitive way, then I don't think they should be brought up at all.
00:23:54.400 --> 00:23:56.799
You also need to be the right person to bring them up.
00:23:56.960 --> 00:23:57.200
Right.
00:23:57.359 --> 00:24:08.640
So I think if you are really close to somebody and feel that you know them well enough to be able to say something like, Look, I I notice you're not at the gym as much as you were before.
00:24:08.960 --> 00:24:09.119
Yeah.
00:24:09.359 --> 00:24:13.039
I just wanted to check in and see if things are going okay.
00:24:13.279 --> 00:24:18.160
You know, that's very different to, well, I haven't seen you at the gym for a while, what's going on.
00:24:18.319 --> 00:24:22.960
You know, there are ways that we can ask these things that seem sort of interrogative or that seem judgmental.
00:24:23.279 --> 00:24:36.319
And there are ways that we can gently inquire that allow space for people while not expecting them to divulge information that would be inappropriate or uncomfortable for them to divulge.
00:24:36.559 --> 00:24:44.319
I think, though, that also the reality of this is that if you're really worried about somebody, it's okay to have an uncomfortable conversation.
00:24:44.480 --> 00:24:47.039
I think we're we're quite frightened of discomfort.
00:24:47.519 --> 00:24:47.759
Yeah.
00:24:48.000 --> 00:24:52.400
And there are some conversations that are never going to be comfortable to have with somebody.
00:24:52.640 --> 00:24:57.519
But I think that it has to depend on your level of concern.
00:24:57.680 --> 00:25:03.440
And I think the level of concern depends on the level of what you kind of seem to be witnessing with that person.
00:25:03.599 --> 00:25:07.680
The other thing I was trying to remember as well was how people are consuming substances as well.
00:25:07.839 --> 00:25:10.720
I think that's a really big thing that often goes unnoticed.
00:25:10.799 --> 00:25:15.440
So, you know, people drinking more alcohol when they're out, um, things of that nature.
00:25:15.599 --> 00:25:19.440
Or even things like they're all of a sudden sleeping significantly more or significantly less.
00:25:19.599 --> 00:25:20.000
Yeah, exactly.
00:25:20.319 --> 00:25:21.519
Sudden changes in behavior like that.
00:25:21.599 --> 00:25:33.440
And the other thing that I want to uh add, which I've already kind of mentioned before, is that um a lot of times, sometimes the change in mental health status is not outwardly evident.
00:25:33.920 --> 00:25:48.319
And uh we we did a postpartum mental health episode about me recently, and we I had this revelation, which was not new at all to you, that my coping mechanism when I'm struggling is to be more productive.
00:25:48.559 --> 00:25:54.240
And when I'm more productive to the unknowing person, they would think, oh my gosh, she's smashing it.
00:25:54.319 --> 00:25:55.359
Yeah, she's doing everything.
00:25:55.440 --> 00:25:56.640
I don't have to check on her at all.
00:25:56.720 --> 00:25:56.880
Yeah.
00:25:57.279 --> 00:25:59.759
But actually, that might be when I'm struggling the most.
00:26:00.319 --> 00:26:18.000
So as the kind of example of that, because we haven't posted the podcast episode yet as a recording, but talking about postpartum, so he cried more during that podcast recording than she had in the entirety of since our daughter was born.
00:26:18.079 --> 00:26:18.400
Yeah.
00:26:18.640 --> 00:26:27.279
And the fact we were talking about it, and I think it gave her a window of opportunity to discuss things, it was like the floodgates opened.
00:26:28.000 --> 00:26:38.160
But despite how upset she was during the podcast, in the week preceding that, we were planning our trip here, we were planning podcast guests.
00:26:38.480 --> 00:26:42.319
I think she said, Maybe I might sign up for a marathon.
00:26:42.400 --> 00:26:44.960
I might sign up for a London marathon, like I could do that again.
00:26:45.119 --> 00:26:47.519
And she she was talking about redecorating our house.
00:26:47.759 --> 00:27:03.759
There were so many things where it looked like she was, well, she was being super productive, but simultaneously, beneath the surface, yeah, even to her, she was obviously battling a lot more in a turmoil than she realized until she talked about it.
00:27:03.839 --> 00:27:05.279
And it was like Yeah.
00:27:05.519 --> 00:27:17.119
And I think it's really common, and I think one of the most one of the most toxic things about social media is that we will often take the things that are happening to us.
00:27:17.359 --> 00:27:26.319
I'm not talking about you, by the way, obviously, but people on social media will post about the things that they are doing that they think are really great.
00:27:26.799 --> 00:27:34.400
And these might be the things that they are doing that might be the most harmful to themselves, yeah, or might be the biggest signs that they are struggling mentally.
00:27:34.640 --> 00:27:42.240
They will do that, they will get the positive feedback loop from social media about how much they're smashing it, and then they will go, I'm doing great.
00:27:42.480 --> 00:27:45.279
This is fine, this is fine, this is fine.
00:27:45.519 --> 00:27:49.119
And they keep embedding perhaps this potentially toxic behavior.
00:27:49.279 --> 00:27:54.240
And what I'm really thinking about when I'm talking about this is things, things like fitness and dieting and stuff, for example, exercise obsession.
00:27:54.640 --> 00:28:01.839
The the um the echo chamber that we get from social media that reinforces our negative behaviors is unreal.
00:28:02.000 --> 00:28:18.880
And I think that sometimes that is one of the hardest things about again, you watch these things happen on social media, and what is one person's absolutely fine is another person's mental difficulties, and it's really difficult to tell the difference sometimes.
00:28:19.200 --> 00:28:31.680
So if you were worried about someone's mental health, how would you try to make them feel comfortable enough to talk to you or confide in you or talk to someone?
00:28:32.000 --> 00:28:32.880
That's a good question.
00:28:32.960 --> 00:28:34.960
I think again, it would depend on the person.
00:28:35.039 --> 00:28:46.400
I think that there are some people who I think you might recognize that you're not the right person for them to talk to, but you might want to encourage them to seek help from others.
00:28:46.640 --> 00:28:53.599
Um you might think that you would be the best person to to speak to about it, everything in between.
00:28:53.920 --> 00:29:07.759
I think that the biggest thing for me is always providing providing spor, I'm I'm only laughing because I was about to say holding space on a podcast, and I know that that's kind of just a bit of a classic parody moment.
00:29:07.920 --> 00:29:08.000
Yeah.
00:29:08.160 --> 00:29:09.599
Are we supposed to be all holding hands right now?
00:29:10.160 --> 00:29:10.799
Exactly, right?
00:29:10.960 --> 00:29:11.200
Yeah.
00:29:11.440 --> 00:29:12.640
But giving people space.
00:29:12.799 --> 00:29:20.559
I think we talk about everyone always says it's good to talk, we should talk more, we should talk to people, but actually I think listening is significantly more important.
00:29:20.799 --> 00:29:30.799
And I think that when we have conversations with people, it's very easy to sometimes just be waiting for the next moment to speak rather than listening to what people are saying.
00:29:30.960 --> 00:29:39.920
I think being comfortable with a little bit of silence, because it's usually in silence where people start to feel a bit more comfortable to open up.
00:29:40.000 --> 00:29:40.319
Yeah.
00:29:40.559 --> 00:29:56.480
And, you know, gentle, gently probing questions like asking people how they're doing, but asking them really how they're doing, asking it a couple of times if you are worried about them, um, asking how specific things are going in their lives, for example.
00:29:57.200 --> 00:30:03.839
I think, I think there's kind of this misunderstanding that people don't like to talk about their problems.
00:30:04.000 --> 00:30:06.480
I think people do like to talk about their problems.
00:30:06.640 --> 00:30:10.319
I think everyone often says that that men aren't very good at talking.
00:30:10.480 --> 00:30:15.599
I think men are great at talking, but they have to be in the right position to talk.
00:30:15.680 --> 00:30:17.200
They have to be in the right situation.
00:30:18.559 --> 00:30:21.839
Well, or whatever is right for them, whatever, wherever it happens.
00:30:22.000 --> 00:30:42.319
You know, there's sometimes I'll be at the gym and I'll have forgotten my headphones, and I will hear groups of guys training together, and suddenly they will just start getting onto really deep feelings, talking about stuff that is quite sensitive, and you realize how quickly that happens when people feel comfortable.
00:30:42.480 --> 00:30:55.440
So I think trying to give people space to allow them to talk, to make them feel listened to, so that they know that if they do talk, you are going to be that voice of compassion, you are going to be that voice of reason.
00:30:55.759 --> 00:30:58.799
That is often what allows people to share things.
00:30:59.119 --> 00:31:01.519
Is it easier to ask what you shouldn't do?
00:31:01.839 --> 00:31:07.519
Are there certain things where you're like, definitely don't do this if you're worried about someone, for example?
00:31:07.839 --> 00:31:15.839
I mean, I think I think it it almost always comes down to judgment for me when it comes to stuff like this.
00:31:16.000 --> 00:31:29.839
I think the biggest mistakes that people make are, you know, for example, if somebody, if somebody was to to share or disclose that they were having, let's say, particularly dark thoughts, thoughts of harming themselves or ending their life or something like that.
00:31:30.160 --> 00:31:34.319
I think people can be quite shocked when they hear somebody say something like that.
00:31:34.640 --> 00:31:39.519
And I think it's understandable if people aren't particularly experienced in in having those sorts of discussions.
00:31:39.680 --> 00:31:44.240
Of course, for me, these are discussions I have all the time at work.
00:31:44.640 --> 00:31:48.799
So I am very comfortable with hearing people talk about those sorts of things.
00:31:48.960 --> 00:31:53.279
And so we do recognize it's not something that other people are as accustomed to hearing.
00:31:53.359 --> 00:31:56.559
So we don't want to say, look, well, why are you why are you seeming shocked by that?
00:31:56.720 --> 00:32:00.559
Of course, they're going to be shocked by it, particularly if it's someone they love or care about.
00:32:00.799 --> 00:32:38.319
But trying really hard in those moments to try and keep a lid on your own emotions and remembering that the conversation is about this person who's struggling, not about how this impacts you, your own anxieties, your own worries or your own concerns, and trying to really, I guess, give yourself almost a bit of mental distance between the words that are being spoken and how those words might make you feel, and just taking a couple of breaths and trying to trying to remain neutral in how you approach it rather than panicking and going, Well, what do you mean?
00:32:38.400 --> 00:32:39.039
What do you mean by that?
00:32:39.200 --> 00:32:41.519
Well, you can't possibly what how could you do that?
00:32:41.599 --> 00:32:51.759
You know, and then a lot of people go down the route of, you know, things like talking about it being selfish or something like that, a lot of kind of societal or ungreased of exactly.
00:32:51.920 --> 00:32:52.240
Yeah.
00:32:52.480 --> 00:32:57.119
And so I think it's just, again, compassion and lack of judgment.
00:32:57.200 --> 00:33:03.359
And if you keep those two words at the forefront of what you're doing, I think that you can't go too far wrong.
00:33:03.599 --> 00:33:15.920
I think if somebody's really struggling, again, they're not always thinking that much about what it is that you're saying, but you might be able to help to guide them in the right direction or the right people to be able to speak to.
00:33:16.240 --> 00:33:30.720
I wonder as well, how much of it for people who are very close to you in your life, let's say it's a fam direct family member, how much of them, how much of it is that they feel like they're being personally blamed because you're I'm a big part of your life.
00:33:30.799 --> 00:33:35.920
And when you tell me you're struggling, you're making me feel like I'm partly responsible for how your mental health status.
00:33:36.000 --> 00:33:38.799
And I don't want to accept that level of responsibility.
00:33:39.279 --> 00:33:43.279
Especially perhaps if you were a younger person speaking to a parent.
00:33:43.519 --> 00:33:43.759
Right.
00:33:44.160 --> 00:33:50.720
I'm living under your roof, under your parenting, under the resources that you're providing, and you're not doing well, that's obviously on me.
00:33:51.119 --> 00:33:52.880
Or you know, you that might they might think that.
00:33:53.200 --> 00:33:54.559
And you also mentioned responsibility.
00:33:54.720 --> 00:34:02.240
So, you know, when somebody discloses thoughts or feelings like that to you, you feel like you are now responsible for keeping them alive, keeping them safe.
00:34:02.400 --> 00:34:02.640
Yeah.
00:34:02.799 --> 00:34:04.799
And that can be terrifying for people.
00:34:04.960 --> 00:34:16.960
And I think, again, you know, remembering that it's and it sounds very callous to say it like this, but it's not your responsibility to keep that person safe.
00:34:17.119 --> 00:34:17.360
Right.
00:34:17.599 --> 00:34:32.639
But it's your responsibility to respond in a way that helps them figure out who they can talk to, how they can keep themselves safe, um, or get them in touch with the professionals who are being paid money to keep them safe.
00:34:32.800 --> 00:34:33.119
Yeah.
00:34:33.360 --> 00:34:45.920
Um, so I think it's it's kind of I I think that a lot of people, when when told anything, when told about people's struggles, feel that it's their responsibility to fix the problem.
00:34:46.159 --> 00:34:54.480
And I think remembering that it's not your responsibility or your job to fix the problem, you just need to listen and to be compassionate and to be there for that person.
00:34:54.719 --> 00:35:03.920
And then sometimes I think when you realize that, you can relax into it a little bit and you can respond with compassion and lack of judgment.
00:35:04.000 --> 00:35:17.039
But I think when you're feeling the weight of the world on you because someone's just disclosed something to you that is heavy, um, I think it can be hard to tap into that compassion and lack of judgment sometimes for some people.
00:35:17.360 --> 00:35:19.599
I don't think you'll mind me saying this.
00:35:19.840 --> 00:35:21.280
We can cut it out if not.
00:35:21.840 --> 00:35:32.719
But recently, when you have talked to me about your feelings postpartum, you have specifically said sometimes you don't want a fix, you want an ear.
00:35:32.960 --> 00:35:33.199
Yes.
00:35:33.440 --> 00:35:37.679
And it's part those are conversations to me, but also with friends.
00:35:37.760 --> 00:35:37.920
Yes.
00:35:38.159 --> 00:35:43.760
Where sometimes if she just wants to offload, she's not doesn't necessarily want someone to say, Have you tried this?
00:35:43.840 --> 00:35:44.239
Do you do this?
00:35:44.400 --> 00:35:44.880
Whatever she's like.
00:35:45.119 --> 00:35:46.400
That might actually make me feel worse.
00:35:46.559 --> 00:35:46.880
Absolutely.
00:35:47.119 --> 00:35:51.679
I don't need a fixer, I need someone who will validate what I'm feeling and say, wow, that really sucks.
00:35:51.760 --> 00:35:51.920
Absolutely.
00:35:52.960 --> 00:35:53.360
Absolutely.
00:35:53.599 --> 00:35:57.199
And I think sometimes the whole all of the conversations don't have to happen at the same time.
00:35:57.440 --> 00:35:57.920
Of course, yeah.
00:35:58.079 --> 00:36:06.159
So I think that in that moment you can take your lead from the person and say, you know, do you is this something that you want me to try and offer you solutions for?
00:36:06.320 --> 00:36:10.559
Or do you just want me to listen for now and have that communication with people?
00:36:10.639 --> 00:36:24.480
And then if you think that they are that like that this is something that does need to be addressed and that does need to be fixed, and that you do you do have a magic solution to that issue, that's something that you can address when they're not in the midst of that particular emotion.
00:36:24.639 --> 00:36:24.800
Yeah.
00:36:24.960 --> 00:36:31.840
You know, if you've put if you've got a practical solution or if you want to work on a practical solution, you can have that conversation with them the next day.
00:36:32.000 --> 00:36:37.519
You know, it doesn't necessarily have to be in the moment when they are complaining about something that happened to them that day.
00:36:37.840 --> 00:36:39.360
Yeah, that's a great response.
00:36:39.840 --> 00:36:46.880
I remember we were all at a fitness event and you were on stage with a microphone with other people on stage on the microphone.
00:36:47.199 --> 00:36:57.039
And someone in the crowd asked a question about why mental health discussions still have a stigma, much like my first question.
00:36:57.760 --> 00:37:06.880
And someone on stage, and this isn't no shade to them, I really like them as a person, as do all of us, said, Do you think that it still has a stigma?
00:37:07.039 --> 00:37:12.719
Because from what I see, it feels like a lot of the stigmas around mental health discussions have actually been lifted a lot.
00:37:12.880 --> 00:37:20.159
It seems like on social media especially, it almost seems like a lot of people are leaning into talking about mental health more.
00:37:20.800 --> 00:37:23.840
Some people might think it comes across as performative sometimes.
00:37:23.920 --> 00:37:26.559
I'm not saying yes or no on that.
00:37:26.800 --> 00:37:33.679
And whilst everyone was kind of seemingly in agreement that, yeah, actually we are talking about mental health a lot more.
00:37:34.000 --> 00:37:41.840
I remember you chiming in and saying, but while we're all talking about mental health, not a single person on this stage has talked about mental illness.
00:37:42.159 --> 00:37:48.079
And I remember being like mic drop moment because mic drop.
00:37:48.480 --> 00:37:48.960
Good.
00:37:49.199 --> 00:37:50.079
Very good.
00:37:50.559 --> 00:37:51.360
Bennadrop.
00:37:51.679 --> 00:37:52.480
Very good.
00:37:53.199 --> 00:37:55.679
And it was, to me, it was like a mic drop moment.
00:37:55.840 --> 00:38:08.880
Number one, because I really appreciated that even in a very non-confrontational way, you were disagreeing with people in a public forum, because I think that's an amazing testament to how much you care about this topic.
00:38:09.119 --> 00:38:20.320
But number two, quite literally that, where it's easy for people on social media to say, I've been through a tough time recently as part of a caption on a post, and it's easy to get likes and things on there.
00:38:20.639 --> 00:38:29.679
But there is still a quite a big dichotomy between talking about mental wellness and mental health and actual mental illness.
00:38:29.840 --> 00:38:30.000
Yeah.
00:38:30.239 --> 00:38:31.840
And I've got a question attached to that.
00:38:31.920 --> 00:38:35.119
I don't know how to phrase it, but I would like you to talk about that.
00:38:35.280 --> 00:38:35.440
Yeah.
00:38:35.599 --> 00:38:36.000
That's okay.
00:38:36.400 --> 00:38:39.440
Yeah, I mean, I think it's a it's a really important distinction.
00:38:39.519 --> 00:38:54.239
And I think it's not just an important distinction between, you know, talking about the difference between mental health and mental illness and and the the stigma of those, but it's also about the stigmas between different mental illnesses as well.
00:38:54.480 --> 00:39:06.079
And how I think that, you know, the spotlight in the world is small and it shines bright on small aspects of big things.
00:39:06.320 --> 00:39:12.639
And so I think we saw for a very long period of time, particularly like around the pandemic, we saw lots of stuff about mental well-being.
00:39:12.719 --> 00:39:14.079
And quite right too.
00:39:14.159 --> 00:39:30.000
You know, people's mental well-being were suffering because of their circumstances, and people had to take more of an active interest in maintaining their mental well-being because they weren't doing all of the stuff that did it automatically for them, like meeting up with friends and going to coffee and all of that sort of stuff.
00:39:30.239 --> 00:39:34.480
Yeah, we were logged inside for four months straight in a very small apartment and that's actually.
00:39:34.639 --> 00:39:35.119
Exactly.
00:39:35.280 --> 00:39:35.599
Yeah.
00:39:35.920 --> 00:39:42.960
Um, but I think that one of the things that we just we don't really talk about.
00:39:43.039 --> 00:39:56.960
I mean, and and we might we might then talk about depression or anxiety because I think that depression and anxiety, I think many people have experienced mild depression or mild anxiety.
00:39:57.199 --> 00:40:03.519
I think a lot more people than people realize will have been to see a doctor about their mood and their well-being.
00:40:03.679 --> 00:40:09.360
And sometimes that will have been something that affected them for a few months and then was better.
00:40:09.519 --> 00:40:15.679
Uh, and for some people, of course, there are much more significant situations and people battle with these things all of their lives.
00:40:15.920 --> 00:40:28.079
And of course, because then people feel that they have some experience of depression or anxiety, they perhaps think that that's where everybody's experience of mental illness lies or ends.
00:40:28.320 --> 00:40:37.039
And because it's much more prevalent and it's much more common, people become more comfortable perhaps talking about depression and talking about anxiety, but it's in a very sanitized way.
00:40:38.000 --> 00:40:58.000
And I think that it's really, you know, when you deal with serious mental illness, when you deal with people with bipolar disorder, with schizophrenia, um, and with the many other mental illnesses that that cause people to, you know, have completely different life paths than what they were expecting.
00:40:58.480 --> 00:41:05.679
I think that that is something that social media and the public generally don't feel super comfortable about.
00:41:06.320 --> 00:41:19.840
I think that when you look at how people with mental illness in the public eye are treated, I think it's pretty embarrassing when we, you know, for us to say that we've reduced stigma.
00:41:20.000 --> 00:41:28.079
Yes, we've reduced stigma, definitely about mental health, definitely about mental well-being, definitely about mind mild mental health disorders.
00:41:28.159 --> 00:41:52.559
Um, but when it comes to serious mental illness, the way that the way that the media discusses people who are suffering, um, the way that it is kind of sensationalized and um, you know, it's kind of dealt with as a spectacle rather than compassionately is I think not great.
00:41:52.880 --> 00:42:01.199
I'm trying to think of an example that didn't feel bad that I was using it as an example, because obviously it's such a personal thing to be discussing.
00:42:01.440 --> 00:42:14.000
But when you said we talk about it in a very sanitized way, me being a very athletic looking person, saying I went through a period of depression is a very easy pill for a lot of people to swallow.
00:42:14.239 --> 00:42:20.960
If I went through a really severe bout of mental illness, that would be a lot harder for some people to swallow.
00:42:21.360 --> 00:42:41.519
And that the most easy, prominent example that I can think of would be something in celebrity culture like Brittany Spears' breakdown that gets plastered on the marked on the tabloids and things like that, and people looking in with this voyeurism and judgmental side.
00:42:41.599 --> 00:42:52.320
And I think there are many examples of when mental health becomes mental illness, suddenly people view it through a very judgmental lens.
00:42:52.639 --> 00:42:53.199
Absolutely.
00:42:53.360 --> 00:43:06.159
And suddenly people's whole uh image changes, people look at them differently, people consider them for different things, and they only want them back when they don't see any trace of of that again.
00:43:06.320 --> 00:43:09.440
And I think that was what was I think very difficult.
00:43:09.760 --> 00:43:26.880
Again, obviously, Britney Spears is an example of a story that we know very little about, I think, um, particularly with regards to the legal aspects of it and with regards to whatever the diagnosis was, whatever the actual situation was and continues to be.
00:43:27.039 --> 00:43:47.599
And I think that what was so interesting about it was the amount of and I definitely think that people I definitely think now, for example, when people speak about Britney Spears, they speak about her more compassionately than they did in 2008 when there were all the paparazzi pictures of her shaving her head and that sort of stuff.
00:43:47.760 --> 00:43:59.760
Um And I think that that is a good thing, but I also think that what would be perhaps better would be people being left alone to be treated and healed appropriate.
00:44:00.159 --> 00:44:05.920
Appropriately as well, rather than it being plastered over the pages of all of the media.
00:44:06.159 --> 00:44:19.599
And it's really difficult because again, I think that people have then tried to behave in a way that they felt was advocating for her in a situation where they felt that she was being unfairly treated.
00:44:19.760 --> 00:44:22.239
And of course, that has to be admired, right?
00:44:22.400 --> 00:44:29.920
That people are trying to advocate for people, but then also we don't know how she should be advocated for because we don't know what her needs are.
00:44:30.079 --> 00:44:33.039
She's not somebody who is in our circle of friends.
00:44:33.360 --> 00:44:35.280
She's somebody who we've seen on the TV.
00:44:35.360 --> 00:44:35.599
Yeah.
00:44:35.760 --> 00:44:40.639
Um, and people form all sorts of opinions from what they see on social media.
00:44:40.800 --> 00:44:43.199
Um, we see it when we have public trials.
00:44:43.440 --> 00:44:47.840
You know, people don't even see all the evidence and they've already solved all of the crimes.
00:44:47.920 --> 00:45:03.760
And it it just is, it's it's it's fascinating to see how the story of mental illness changes, but I definitely still think that we're a very long way off of and I don't know that we can normalize mental illness because it's hard and it's not, it isn't, it's not nice.
00:45:03.840 --> 00:45:06.320
It's you know, I don't know that we want to see people.
00:45:06.559 --> 00:45:22.239
I remember there was a a really prominent guy on Twitter who started being very open about his diagnosis of schizophrenia and started tweeting a lot about it, and then he went through a relapse and he was tweeting through his relapse.
00:45:22.400 --> 00:45:40.239
And I think I felt again it felt very voyeuristic, it felt like he was very vulnerable, it felt like I didn't know, you know, in some ways I thought, okay, well, perhaps it's good for people to see this, but I don't think it's good for that person to be so exposed.
00:45:40.400 --> 00:46:00.719
And I think that's what's really difficult about it is I I don't actually know what the right way is to reduce the stigma of mental illness apart from accepting that it happens and when it happens, treating people with compassion and lack of judgment, going back to everything we we've talked about before, rather than treating with them treating them as a as a show.
00:46:01.280 --> 00:46:01.679
Yeah.
00:46:02.000 --> 00:46:03.280
I think that's very fair.
00:46:03.599 --> 00:46:16.000
How much of poor mental health is the byproduct of subpar sleep, diet, nutrition, the same thing, exercise versus an actual something that requires a completely different intervention?
00:46:16.320 --> 00:46:20.880
I mean, I think it can be completely one or completely the other and everything in between.
00:46:20.960 --> 00:46:23.280
I don't think there's a there's a real specific answer.
00:46:23.519 --> 00:46:31.039
I think for there are some people who will be suffering from considerable mental health difficulties entirely because of their lifestyle.
00:46:31.199 --> 00:46:34.159
And if they change their lifestyle, yeah, they'll do much better.
00:46:34.480 --> 00:46:41.599
And then there can be some people who are doing absolutely everything 100% optimally and will still be suffering.
00:46:41.760 --> 00:46:41.920
Yeah.
00:46:42.079 --> 00:46:44.079
Um, and I think that's what makes it so tricky.
00:46:44.159 --> 00:47:01.440
And I think that's what often leads people to struggle to seek help is I think th that that kind of cohort of people where, you know, sometimes people will come to me and say, I do not understand why I cannot stop crying and I don't want to eat anything and I'm not sleeping properly, because my life is objectively perfect.
00:47:01.679 --> 00:47:08.400
You know, I have everything that I need, I have everything I ever wanted, but I feel despair and I don't know why.
00:47:08.559 --> 00:47:10.400
And I think that can be much harder for people.
00:47:10.480 --> 00:47:17.760
I think it's often easier for people to seek help if they if they should feel if they feel they should feel bad, because again, it's that feeling of guilt.
00:47:17.840 --> 00:47:18.639
Why do I feel bad?
00:47:18.800 --> 00:47:19.760
Am I being ungrateful?
00:47:19.920 --> 00:47:20.880
Am I being privileged?
00:47:20.960 --> 00:47:21.119
Yeah.
00:47:21.280 --> 00:47:33.679
And I think that's the thing that that frustrates me so much about that conversation about privilege is because, well, yes, we might feel privileged, but if we are privileged, then we should also be happy.
00:47:34.000 --> 00:47:42.079
The the example that I use when we were on the postpartum episode was with celebrities, for example.
00:47:42.400 --> 00:47:59.360
If a s a wealthy celebrity was reported to be having mental health issues, a lot of people would say things along the lines of, well, it should be easy for them, look how much money they have, they can afford the best therapist, all of those kind of things.
00:47:59.679 --> 00:48:05.039
But if it got to the point where that celebrity committed suicide, everyone would pour in sympathy.
00:48:05.360 --> 00:48:06.000
Yeah.
00:48:06.559 --> 00:48:08.800
I I agree.
00:48:08.880 --> 00:48:19.920
And I think again, we've seen that a lot of times when um you know, when celebrities have been open about something and you can see them get torn to shreds and then be like, oh, it's so sad they're gone.
00:48:20.159 --> 00:48:21.119
Yeah, absolutely.
00:48:21.360 --> 00:48:48.480
And I think that there is, you know, it is difficult because people are living a public life, and we know that particularly I think in in a lot of sector a lot of sectors of our society, or at least a lot of a lot of cultures, people don't feel sympathy for people who have objectively good lives um or who have what they might want.
00:48:48.719 --> 00:48:52.719
And so I guess it we know that.
00:48:53.199 --> 00:49:00.719
And I think that it it would be really nice if we could change how people were, but I don't know how we do.
00:49:01.119 --> 00:49:24.320
I think you know, if we haven't seen that happen enough times by now, whereby people have been, you know, horrendously treated by the media and by the general public and have gone on to take their own lives, and then for people to you know, the same people who probably were making negative comments about them to then post about, you know, may they rest in peace.
00:49:25.119 --> 00:49:27.840
I don't know how we're gonna teach that to people.
00:49:28.159 --> 00:49:37.440
And it just it always alarms me that we have this culture whereby people want to make negative comments on other people for no reason.
00:49:37.679 --> 00:49:48.639
Like I'm no stranger to disagreeing with people on the internet and you know, disagreeing with posts or making a comment on a post that I don't agree with.
00:49:49.440 --> 00:49:56.480
But I don't I don't think that we should be just being horrible to people on the internet.
00:49:56.800 --> 00:50:06.639
And I I don't know that I necessarily realized how prevalent it was until I I posted a video of um a dumbbell rack falling on me.
00:50:07.360 --> 00:50:07.599
Oh yes.
00:50:07.840 --> 00:50:10.079
Yeah, and it was and it went viral.
00:50:10.320 --> 00:50:13.519
I talked to you during that week actually, and you were like the amount of hate I'm getting issues.
00:50:13.679 --> 00:50:14.719
Yeah, and I was like, but I didn't think that's what I'm saying.
00:50:15.199 --> 00:50:15.920
What were they saying?
00:50:16.239 --> 00:50:24.880
I mean, they would just people would say stuff like I can put the video on the screen, but for context, anyone listening was you were doing an exercise where a resistance band was attacking.
00:50:26.960 --> 00:50:28.960
With a band assisted Nordic curl.
00:50:32.079 --> 00:50:34.239
Which could have been legitimately catastrophic.
00:50:35.920 --> 00:50:36.400
Absolutely.
00:50:36.639 --> 00:50:38.400
And uh and yet here we are.
00:50:38.559 --> 00:50:39.760
Um very lucky.
00:50:39.920 --> 00:51:01.280
And I actually didn't post the video because I thought I don't really want to post a, you know, like a gym fail video or a or an injury video, because I it was a little bit and it was a little bit upsetting in a way, because you know, watching the video back, it was like, oh my goodness, it looked so much worse than it was that in a way I could have quite literally died with heavy dumbbells falling off.
00:51:01.679 --> 00:51:06.400
Although ironically, I think if the dumb if the heavy dumbbells had been there, it wouldn't have rolled over.
00:51:06.639 --> 00:51:11.679
Um but I think that that you know I I didn't really want to post it in case it was too graphic.
00:51:11.840 --> 00:51:25.280
And so it was it was almost two years after it happened that I actually I was thinking I was trying to make a meme about something to do with like, you know, um trying to eat healthily, but then the Easter holidays come along and that's the dumbbell rack.
00:51:25.599 --> 00:51:28.480
And I and so and I was trying to think of a you know a meme to make with it.
00:51:28.559 --> 00:51:31.119
And I was like, oh, I could use that video of the dumbbell rat falling on me.
00:51:31.360 --> 00:51:34.320
And I genuinely didn't think that much of it.
00:51:34.639 --> 00:51:40.239
I just thought I was posting it as a funny meme, and then it was like it got six million views.
00:51:40.559 --> 00:51:56.880
And it it was it was just it was the fact that people were so like they were so gleeful about oh, I hope, I hope he was really badly injured, or you know, some someone doing that something that stupid should never be allowed in a gym.
00:51:57.039 --> 00:52:04.480
And then of course attacking my credentials, like saying, you know, like I can't believe that I would never speak to a person like that about mental health.
00:52:04.639 --> 00:52:10.400
And obviously that is something that you're a doctor, you're not an engineer, you didn't calculate the animal.
00:52:10.880 --> 00:52:18.159
And like and you know, there was a point where I was like at some points replying to these comments, just saying, have you never like made a mistake before?
00:52:18.559 --> 00:52:18.639
Yeah.
00:52:18.800 --> 00:52:27.119
And I think it was really interesting that when you actually challenged people, they either had nothing to say or they just thought it was they're like, Why are you replying to these comments?
00:52:27.199 --> 00:52:31.199
Yeah, it's like, oh, well, you just and then they were like, I can't believe you're replying to comments.
00:52:31.920 --> 00:52:33.920
Well, I'm a human being about you, but don't respond.
00:52:34.320 --> 00:52:34.880
Don't respond to me.
00:52:36.000 --> 00:52:47.280
And it was just, it was such a strange kind of insight into this kind of sector of society that I'd never really been exposed to before because my content on social media is just like I know, right?
00:52:47.440 --> 00:52:50.000
Um, not very often seen by six million people.
00:52:50.079 --> 00:52:52.639
But is that is that the thing you want to be most known for?
00:52:52.880 --> 00:52:53.039
Exactly.
00:52:53.119 --> 00:52:56.480
And then I was and then suddenly I was like, oh my god, I can't believe this is my legacy.
00:52:56.639 --> 00:53:08.719
This is like I've spent 10 years posting on social media, trying to post like educational content and trying to get people to talk more about mental health or fitness or lifestyle change or any of these things, then then this is what I'm this is what I'm gonna be remembered for.
00:53:08.880 --> 00:53:11.199
Snoop Dogg posted it, he reshared it.
00:53:11.280 --> 00:53:15.679
Like it was, it was like the the most crazy thing ever.
00:53:15.920 --> 00:53:30.480
Um, and obviously, like I got my sense of humor back about it eventually, but there was a period of time where I was like, I don't really want to post on social media now because this is if if these are the people that I'm talking to, then what like what am I what am I doing here?
00:53:30.639 --> 00:53:32.880
Why am I putting all of this effort into this?
00:53:33.119 --> 00:53:37.280
Um, and it's it's you know, it's like what we were talking about before.
00:53:37.519 --> 00:53:41.440
None of us are immune to the effects of anything.
00:53:41.599 --> 00:53:46.719
And there have been times in the past where people have said things to me on social media that weren't very nice and I didn't care.
00:53:46.960 --> 00:53:49.519
And there were times since that people have said things and I didn't care.
00:53:49.679 --> 00:53:49.920
Sure.
00:53:50.079 --> 00:53:57.599
But at that moment in time, for that week or whatever, yeah, it was like every time I woke up in the morning, the first thing I did was, oh, what are people saying now?
00:53:57.679 --> 00:53:59.199
Like, what are the new things that people have said?
00:53:59.360 --> 00:54:02.079
And looking back on it, I was like, Well, why did it even bother you?
00:54:02.159 --> 00:54:03.599
But it's like in the moment, sure.
00:54:03.840 --> 00:54:05.199
These things can feel quite big.
00:54:05.280 --> 00:54:05.519
Yeah.
00:54:05.760 --> 00:54:13.679
And so I think, you know, that's why I kind of feel like imagine that multiplied by millions and millions.
00:54:13.760 --> 00:54:21.440
And I guess it comes to a, you know, it got to a point where there were so many comments I couldn't even read them all, which was fun, because then I didn't need to know about it.
00:54:21.519 --> 00:54:27.840
Um, and I guess that's what, you know, I guess perhaps it gets to that point with celebrities where they just have to get good at ignoring it.
00:54:28.000 --> 00:54:28.960
But why should they?
00:54:29.119 --> 00:54:30.719
You know, they are human beings as well.
00:54:31.360 --> 00:54:39.440
I've said this with social media, I feel like the the bigger your audience gets, you either get a thicker skin.
00:54:39.920 --> 00:54:47.199
And I think sometimes you can almost become a little bit, I'm not using, I know I'm not using this correctly, don't feel the need to correct, we're being loose.
00:54:47.360 --> 00:54:51.199
But you almost become a little bit sociopathic where you have to detach from it completely.
00:54:51.280 --> 00:54:51.519
Yeah.
00:54:51.760 --> 00:54:53.199
Because you can't, yeah.
00:54:53.360 --> 00:54:57.840
I can't read all of my comments on every single platform without it.
00:54:58.320 --> 00:55:04.719
I wouldn't say it would destroy my mental health, but you just at some point you realize it's not good for you.
00:55:04.960 --> 00:55:05.760
Yeah, it doesn't make you feel good.
00:55:06.079 --> 00:55:07.119
I make nutrition videos.
00:55:07.199 --> 00:55:10.880
I very rarely make anything that's actually that controversial.
00:55:11.119 --> 00:55:20.559
I still get comments from people and messages from people telling me that I'm ugly, telling me to kill myself, like ridiculous things for the context of what I'm posting.
00:55:20.639 --> 00:55:20.800
Yeah.
00:55:20.960 --> 00:55:25.679
It's not like I'm addressing serious world issues where there's a real political divide.
00:55:25.920 --> 00:55:29.679
So I think when you get a big enough platform, you just have to accept that that's part and parcel.
00:55:29.920 --> 00:55:30.079
Absolutely.
00:55:31.119 --> 00:55:31.280
Yeah.
00:55:31.679 --> 00:55:31.920
Yeah.
00:55:32.159 --> 00:55:47.039
I one thing that reminds me, that reminds me of with social media or with celebrities is that when people talk about, let's say you're viral post, they're leaving nasty comments about you or to you, quote unquote, to you, it's one thing, right?
00:55:47.199 --> 00:55:49.440
Or you say something nasty about a celebrity is one thing.
00:55:49.519 --> 00:56:02.559
But then when that person responds to your comment, or to take a step further, if they then make a response video that highlights your username, your profile, what you said, all of a sudden you're now the bully.
00:56:02.639 --> 00:56:02.880
Yeah.
00:56:03.039 --> 00:56:05.440
Because how dare you harm their mental health?
00:56:05.519 --> 00:56:05.679
Yeah.
00:56:05.840 --> 00:56:08.400
Even if they were the actual original perpetrators.
00:56:08.719 --> 00:56:09.519
So I find that interesting.
00:56:09.840 --> 00:56:21.679
Well, I think it's it's it's a really interesting discussion about empathy because I think it's the fact that that person isn't feeling empathy for you because they can't imagine what it must feel like to be having lots of comments.
00:56:21.840 --> 00:56:22.000
Yeah.
00:56:22.239 --> 00:56:28.159
Because usually they're like a, you know, a locked profile that doesn't have like a following, for example, or doesn't post on Instagram.
00:56:28.320 --> 00:56:30.719
So they don't have the experience of what it feels like.
00:56:30.960 --> 00:56:35.360
And then when they experience that, suddenly it's quite shocking and upsetting.
00:56:35.840 --> 00:56:39.679
And they realize this isn't nice at all and it feels like bullying.
00:56:39.840 --> 00:56:53.679
And I think sometimes there's that disconnect whereby they don't realize that that's what they were doing to you because they see you as a um, I'm not talking about me, by the way, in that in that process, but they see the celebrity as a as somebody who is untouchable.
00:56:53.760 --> 00:56:54.000
Yeah.
00:56:54.159 --> 00:56:56.079
Who nothing I could say could upset them.
00:56:56.159 --> 00:57:14.400
And I guess it's, you know, in some ways, it's like I'd feel more comfortable making a response video to something I disagree with of somebody who's got 20 million followers who's never going to see my response video than I would about somebody who has a small following who might not like being highlighted to a large number of people.
00:57:14.639 --> 00:57:29.920
So I think it is, you know, I think it just kind of speaks to that real when people are on social media, they're generally focusing on their own experience and how they feel rather than perhaps how what they're doing might make others feel.
00:57:30.239 --> 00:57:42.639
That actually reminded me, I think four, maybe five years ago, someone left a nasty comment about one of my videos, something about my insufferable wife or something.
00:57:42.800 --> 00:57:44.480
And people can insult me all day long.
00:57:44.559 --> 00:57:48.000
And normally it's like water off the duck's back, I'd be it on social media, it's part and parcel.
00:57:48.079 --> 00:57:48.239
Yeah.
00:57:48.320 --> 00:57:51.840
But there was something about the fact that this guy was insulting my wife.
00:57:52.000 --> 00:57:52.159
Yeah.
00:57:52.400 --> 00:57:59.440
Where I made a video and it was a it was a very kind of light-hearted, I think I'd put some dramatic music over it or something.
00:57:59.760 --> 00:58:02.320
And we went on with our day, and that was it.
00:58:02.480 --> 00:58:08.639
And then later, I not only had a barrage of messages, but missed calls on Instagram.
00:58:08.800 --> 00:58:09.280
Oh wow.
00:58:09.440 --> 00:58:14.639
And he was very upset about the fact that I had replied to his comment, but I was like, it's a public comment.
00:58:14.800 --> 00:58:18.239
He hasn't sent me a message or an email and I've put it on there.
00:58:18.400 --> 00:58:19.840
It's he's put a public comment.
00:58:19.920 --> 00:58:20.239
Yeah.
00:58:20.400 --> 00:58:23.840
Everyone could still see it, and I've replied to it on video form, and then he was.
00:58:24.079 --> 00:58:27.440
And all of a sudden it was, my job's in jeopardy, blah, blah, blah, blah, blah.
00:58:27.599 --> 00:58:29.039
But my reputation, this and that.
00:58:29.360 --> 00:58:32.960
I don't think you're going to get fired over calling someone's wife insufferable, but even so.
00:58:33.280 --> 00:58:35.039
But it's interesting that people don't.
00:58:35.519 --> 00:58:37.599
I think it's the it's the lack of accountability.
00:58:38.159 --> 00:58:42.079
It didn't say sorry, that message was a bit it was why you doing this.
00:58:42.400 --> 00:58:44.159
And I didn't even we were going on with our day.
00:58:47.440 --> 00:58:48.880
Anywho, side tangent.
00:58:49.280 --> 00:59:05.519
Uh as a doctor, I know that you're in a unique position to answer some questions that some people are perhaps less suited to answer because your relationship with mental health and where you meet people with their mental health is very different to most people chatting about mental health on social media.
00:59:05.760 --> 00:59:16.719
Anyway, so one of those questions is why do you think modern medicine is better at treating versus preventing?
00:59:17.679 --> 00:59:19.840
I think that's a really interesting question.
00:59:19.920 --> 00:59:23.360
And I think that there are lots of different answers to it.
00:59:23.519 --> 00:59:26.960
There's l lots of ways of tackling that question, lots of ways of thinking about it.
00:59:27.039 --> 00:59:33.440
And it's something that I've gone round and round in circles on in my own mind and in my own career.
00:59:33.760 --> 00:59:41.519
Because of course, we know that you know, as much as we possibly can, we should be focusing more on prevention than treatment.
00:59:42.079 --> 00:59:46.960
I think that in many cases prevention is not possible at all.
00:59:47.280 --> 00:59:54.800
And in many cases, prevention is not practically possible because of other restrictions that people have on their lives.
00:59:55.360 --> 01:00:04.719
And I think that the what's interesting to think about is like who can have the biggest impact on disease prevention.
01:00:05.119 --> 01:00:08.480
Is it a doctor or is it the politicians?
01:00:08.639 --> 01:00:09.519
Is it the government?
01:00:09.679 --> 01:00:13.679
Is it um the socioeconomic environment that we grow up in?
01:00:13.840 --> 01:00:28.960
Is it our access to food, our access to healthcare, our access to safe physical activity, and our access to all of the things that can help prevent the diseases that we're talking about preventing, or is it a doctor telling us to eat more vegetables?
01:00:29.519 --> 01:00:46.559
And I think that what's really interesting is that I think people have this kind of conception that doctors just dish out medication rather than uh focusing on things like lifestyle aspects of that, we'll get to that as well.
01:00:47.679 --> 01:00:55.119
But I think that we have to think about what the doctor's job is and what the job is of everything else.
01:00:55.280 --> 01:01:08.400
Like what if you want to get the most out of any professional, particularly a professional that can be hard to access, you kind of want to be using them for only the things that only they can do.
01:01:09.119 --> 01:01:12.239
And the other things can come from elsewhere.
01:01:12.559 --> 01:01:22.320
So if you want to go and see a mechanic and a mechanic is really expensive, you don't want to also pay that mechanic's hourly rate to wash your car, for example.
01:01:22.480 --> 01:01:23.840
You can go to a car wash and wash your car.
01:01:24.079 --> 01:01:25.119
That's a great analogy.
01:01:25.360 --> 01:01:25.679
Exactly.
01:01:25.760 --> 01:01:26.000
Thank you.
01:01:26.159 --> 01:01:27.039
I just thought of it on the spot.
01:01:27.360 --> 01:01:28.800
I wondered if it was one you'd use before.
01:01:28.960 --> 01:01:29.679
That was really good.
01:01:30.239 --> 01:01:35.760
But you want the mechanic to do the things that they are skilled at doing in fixing the problems in your car.
01:01:36.079 --> 01:01:44.000
Um, so I think by the same token, we need to be looking at, you know, where should disease prevention happen?
01:01:44.239 --> 01:02:00.400
It should happen in society, it should happen at school, it should happen through government initiatives, it should happen through improving our environments and making it easier for people to lead healthier lifestyles.
01:02:01.679 --> 01:02:03.920
I think that there isn't enough pressure.
01:02:04.079 --> 01:02:08.800
You know, we talk about personal responsibility versus, you know, governmental initiatives and things like that.
01:02:08.880 --> 01:02:17.199
And it's a really hard conversation to have because at the end of the day, we can't fix government initiatives today or tomorrow or next week or in the next 10 years, probably.
01:02:17.440 --> 01:02:22.719
But we can tell people what they can do in their own lives to try and improve their health.
01:02:22.880 --> 01:02:25.920
So it is a very complicated conversation to have.
01:02:27.199 --> 01:02:32.639
But I don't think that medicine is the best place for disease prevention.
01:02:32.719 --> 01:02:38.639
I think disease prevention is incredibly important, but I don't think doctors are the best people at doing it.
01:02:39.039 --> 01:02:49.039
I think I read somewhere that that's where personal trainers and dietitians and other people, that's where they have more efficacy in terms of helping prevent.
01:02:49.360 --> 01:02:49.760
Absolutely.
01:02:50.000 --> 01:02:57.679
And if I if I can help reduce the likelihood that you will then need to go to the doctor to get the medicine or receive some kind of intervention, then I've done my job.
01:02:58.000 --> 01:02:58.239
Yeah.
01:02:58.480 --> 01:03:06.800
And the hardest thing about that is that often those professionals are much more easily accessible to people with privilege.
01:03:06.880 --> 01:03:16.159
Um, and that's what makes it so tricky because again, particularly like in the UK, we have the NHS, so somebody can book an appointment.
01:03:16.320 --> 01:03:20.400
I know it's hard to book appointments with the GP, but see you in nine months.
01:03:20.719 --> 01:03:21.840
Oh, sorry.
01:03:22.320 --> 01:03:25.760
Um that's another conversation.
01:03:25.920 --> 01:03:52.239
Um but people can book an appointment with their GP and they can have expectations of their GP that might not be realistic in terms of that person's skills because they can't afford a personal trainer or a nutritionist or um if you know a private physio or chiropractor, osteopath or any of those sort of sorts of things that happen kind of in the private sector, um, it can just be very difficult.
01:03:52.400 --> 01:03:58.000
And I think that that's what often leads to people thinking, well, why why doesn't the GP do the disease prevention?
01:03:58.320 --> 01:04:01.760
And I think there's a there's a role for it, and of course we should talk about it.
01:04:01.920 --> 01:04:20.480
But if you've got if you've got 10 minutes to talk about how to lower your cholesterol with somebody, you know, your your bigger role is is you know, how that's gonna happen perhaps chemically rather than how it's gonna happen with all of the different lifestyle interventions that they can read up on on a website.
01:04:20.719 --> 01:04:20.960
Sure.
01:04:21.119 --> 01:04:26.159
Or I can read out the list of things that they can avoid in their diet to help with their cholesterol.
01:04:26.400 --> 01:04:29.039
It's not a great use of that 10-minute appointment, I guess.
01:04:29.440 --> 01:04:39.840
And also everything you've said reminds me of the super important point that tends to make a lot of people angry, which is that one of the biggest factors that determines your health status is money.
01:04:40.079 --> 01:04:40.239
Yeah.
01:04:40.719 --> 01:04:45.920
And people don't like to hear that because again, it goes back to the responses I've gotten include push-ups are free.
01:04:46.079 --> 01:04:46.239
Yeah.
01:04:46.480 --> 01:04:48.239
As if push-ups are the one thing.
01:04:48.639 --> 01:04:48.880
That's it.
01:04:48.960 --> 01:04:49.599
Yes, push-ups.
01:04:49.920 --> 01:04:56.800
That is it, not financial stress, food insecurity, safe neighborhoods.
01:04:56.960 --> 01:04:58.480
And now I'm going into onto my rant.
01:04:58.639 --> 01:05:00.000
So we're not gonna dive into that.
01:05:00.079 --> 01:05:01.280
But yeah, absolutely.
01:05:01.599 --> 01:05:04.159
And poverty is one of the biggest predictors of disease as well.
01:05:04.719 --> 01:05:13.199
And I think that if we fixed poverty, we would fix we would do a lot of disease prevention, way more than modern medicine's gonna do in a clinic.
01:05:13.440 --> 01:05:13.760
Yeah.
01:05:14.079 --> 01:05:19.440
I don't want to talk about this in too much detail because it feels like we're talking about the least interesting thing about you.
01:05:19.599 --> 01:05:25.280
But I know on social media, you have posted occasionally that you have lost a significant amount of weight.
01:05:25.440 --> 01:05:27.360
You said around a third of your body weight-ish.
01:05:28.159 --> 01:05:35.679
How has that experience impacted how you talk to patients, perhaps versus what you learned in training?
01:05:36.000 --> 01:05:37.280
That's a really interesting question.
01:05:37.360 --> 01:05:40.079
And I think it continues to evolve as time goes on.
01:05:40.239 --> 01:05:49.280
And because I think as anyone who has ever gone on any sort of weight loss or lifestyle change will know, it doesn't just stop at the end of that phase.
01:05:49.440 --> 01:05:58.239
It then is kind of this lifelong attempt at trying to continue to lead a healthy lifestyle and all of the challenges that come with that.
01:05:58.480 --> 01:06:16.320
But I think what's really interesting about About it is that it really highlights how different people feel about weight and how sometimes the most toxic thoughts and the most toxic people are the people who have been successful at something that other people struggle to do.
01:06:16.559 --> 01:06:19.440
And I think it's really something that can affect all of us.
01:06:19.519 --> 01:06:21.360
And I think that's a lot more about this.
01:06:21.679 --> 01:06:44.159
Well, I think that so, for example, to just contextualize, the reason that I had been overweight was because I had never had any interest in physical activity and I had never had any interest in nutrition, and I really liked eating lots of food, and I really enjoyed, you know, particularly like junk food and stuff like that.
01:06:44.400 --> 01:06:51.119
And I was busy and I lived through, you know, wanting to just eating how I wanted to.
01:06:51.440 --> 01:06:54.559
And it had an impact on my weight, it had an impact on my health.
01:06:54.800 --> 01:07:15.119
And when I decided that it was something that I should perhaps do something about, I was in the privileged position of being able to join a gym, get a personal trainer, um have knowledge about some nutritional things that even wasn't enough to stop me from doing some silly diet things as well.
01:07:16.079 --> 01:07:22.800
But the process for me was was pretty straightforward actually, once I'd got it right.
01:07:23.599 --> 01:07:28.480
And I think when you do something, and it, you know, it was, it was kind of a few years and it was, it was great.
01:07:28.559 --> 01:07:35.039
Like I felt very proud of myself and I got congratulated by everybody, and that was great, and it really kind of validated what I'd done.
01:07:35.199 --> 01:07:37.280
And it was, you know, in some ways difficult.
01:07:37.360 --> 01:07:40.480
So I thought I'd done something really, really hard and I was very proud of myself.
01:07:40.559 --> 01:07:47.440
I was very pleased with myself, but it also made me just made me feel like, oh, well, if I can do it, everybody else can.
01:07:47.760 --> 01:07:48.000
Yeah.
01:07:48.239 --> 01:08:04.480
And it's interesting when you first start having those discussions, because I think when I was very overweight and I would have discussions about weight with people, they would often feel quite comfortable talking to me about it because they could see that I had the same issues that they did on the outward side of things.
01:08:04.719 --> 01:08:09.920
Um, but after I'd lost weight, I kind of got that glazed over look that I couldn't possibly understand.
01:08:10.000 --> 01:08:11.599
Oh, because how would you know?
01:08:11.840 --> 01:08:12.480
How would you know?
01:08:12.639 --> 01:08:12.800
Yeah.
01:08:13.039 --> 01:08:16.319
And yet in my mind, I was like, well, I know.
01:08:16.640 --> 01:08:17.920
But I didn't know.
01:08:18.079 --> 01:08:20.319
And I would come up with ideas for people.
01:08:20.399 --> 01:08:22.000
Oh, do you just it's just a calorie deficit?
01:08:22.079 --> 01:08:22.800
You just need to do this.
01:08:22.960 --> 01:08:26.079
And you know, all of the things that we hear, we hear people do.
01:08:26.399 --> 01:08:27.920
Have you tried eating less and moving more?
01:08:28.159 --> 01:08:28.560
Exactly.
01:08:28.720 --> 01:08:32.000
And it is, it is actually turns out it is about eating less and moving more.
01:08:32.159 --> 01:08:37.439
And it was for me because it was quite a simple, it was quite a simple process.
01:08:37.600 --> 01:08:40.560
I did need to eat less and I did need to move more.
01:08:40.720 --> 01:08:48.720
But for other people, the challenges are different and the process is different, and the privilege is different, and the lifestyles are different, and the caring responsibilities are different.
01:08:48.800 --> 01:08:49.039
Yes.
01:08:49.279 --> 01:08:53.119
And the inability to go to the gym because you have babies to look after is different.
01:08:53.279 --> 01:08:56.319
And all of the things that that go along with it.
01:08:56.720 --> 01:09:07.840
And I got re-taught that after I had had my weight loss journey so that I could then not be that toxic person who just thinks it's really easy for everybody.
01:09:08.000 --> 01:09:10.319
Um, and I think that we do see that a lot.
01:09:10.399 --> 01:09:20.159
We see it, it's, you know, you become the equivalent of the um the wealthy, privileged influencer who says we've all got the same 24 hours in a day, right?
01:09:20.399 --> 01:09:22.079
You've just got to prioritize it.
01:09:22.319 --> 01:09:24.720
But then the hard thing about-devilla and Bali.
01:09:25.119 --> 01:09:25.760
Exactly.
01:09:26.000 --> 01:09:49.279
But then the hard thing about that is that you there is this distinction between personal responsibility and the reality that, yes, you do have all of these problems, you do have all of these challenges, but the government isn't going to suddenly change all of this and allow you to have access to all of the things that you need to engage in a healthy lifestyle.
01:09:49.439 --> 01:09:56.479
You are actually going to have to figure out a way to do it or to just accept that you're going to be unwell.
01:09:56.720 --> 01:10:03.119
So it's about then working with people and figuring out what they can do and the realization that you don't have to do everything.
01:10:03.279 --> 01:10:07.199
And these tiny incremental changes can make huge differences.
01:10:07.279 --> 01:10:15.039
And you also don't need to do things to such a high standard or such an intent standard.
01:10:15.199 --> 01:10:19.199
You know, people don't need to develop a sick pack, as we know.
01:10:19.279 --> 01:10:23.359
And, you know, you guys have talked about this extensively in all of your content for such a long time.
01:10:23.439 --> 01:10:25.359
You don't need to be super lean to be healthy.
01:10:25.439 --> 01:10:25.600
Yeah.
01:10:25.760 --> 01:10:28.880
It doesn't necessarily even mean that you are healthy if you are super lean.
01:10:29.119 --> 01:10:47.439
But, you know, if somebody, if somebody loses an amount of weight that isn't even visible to other people or to themselves, even the behaviors that they are engaging in in order to establish that weight loss, presuming that those are healthy behaviors, are going to be improving their health markers in other ways.
01:10:47.600 --> 01:10:51.920
So it's not saying, right, well, you have to lose 20 kilos or there's no point.
01:10:52.079 --> 01:11:02.720
It's about meeting people where they're at and trying to help them make small incremental changes that can have big impacts on their lifestyle and it not being about weight loss.
01:11:03.119 --> 01:11:03.760
Yeah.
01:11:04.239 --> 01:11:04.800
I like that.
01:11:04.960 --> 01:11:15.920
I feel like that puts a lot of emphasis, emphasis on understanding, even if it's true that someone does need to eat less and move more, there are different barriers to making that happen.
01:11:16.319 --> 01:11:27.439
And also I think being the compassionate person that you are, you're more likely to see those barriers and not then say, Well, have you tried cutting carbs?
01:11:27.600 --> 01:11:27.840
Yeah.
01:11:28.079 --> 01:11:29.680
Have you tried going for a run more?
01:11:29.840 --> 01:11:30.239
Yeah.
01:11:30.560 --> 01:11:31.520
Anything like that.
01:11:32.239 --> 01:11:36.800
There are a lot of criticisms on social media of doctors nowadays.
01:11:36.880 --> 01:11:40.560
And I have talked I have talked to you extensively about them.
01:11:40.640 --> 01:11:43.039
And I often find myself sticking up for doctors.
01:11:43.119 --> 01:11:43.199
Yeah.
01:11:43.279 --> 01:11:43.439
Yeah.
01:11:43.680 --> 01:11:45.840
Despite the fact a lot of personal trainers don't.
01:11:46.239 --> 01:11:52.720
So I would like to do some fairly rapid fire statements just to get your opinion on them.
01:11:53.279 --> 01:11:56.239
So doctors don't actually care about health.
01:11:56.399 --> 01:11:58.800
They only care about pushing pills on people.
01:11:59.039 --> 01:12:00.720
How fair is that criticism?
01:12:01.119 --> 01:12:07.359
I think unfair, I think that people underestimate the power of medication and how useful it is to treat conditions.
01:12:07.520 --> 01:12:16.239
And again, like we were talking about earlier with the distinction between different professions, the doctor's the only one who can prescribe medication.
01:12:16.479 --> 01:12:31.520
So it stands to reason that when you see a doctor, they might, you know, if I see a patient and I say, well, let's refer you to the well-being service, or let's get you to do some, to self-refer yourself for some talking therapies or something like that.
01:12:31.920 --> 01:12:35.359
But let's also, or we discuss and decide to start medication.
01:12:35.439 --> 01:12:38.479
That patient might walk away and go, well, all he did was give me medication.
01:12:38.640 --> 01:12:43.199
Yeah, because I didn't deliver the counseling or the talking therapies or the lifestyle advice.
01:12:43.359 --> 01:12:49.920
I signposted people to the lifestyle advice because it's not the best use of that time.
01:12:50.079 --> 01:12:55.680
Because if I do the lifestyle advice, then who's going to do the prescribing, but there's someone else who could do the lifestyle advice.
01:12:55.920 --> 01:13:00.720
But I also accept that there are also doctors who don't do the lifestyle advice in the first place.
01:13:00.880 --> 01:13:02.079
It's easy for me to say this.
01:13:02.159 --> 01:13:02.319
Yeah.
01:13:02.560 --> 01:13:10.800
I can only comment on how I practice and the kind of culture that I like to foster or have fostered around me.
01:13:10.960 --> 01:13:14.960
Um, but again, every clinic, every doctor is a different experience.
01:13:15.199 --> 01:13:19.439
And I think people forget that doctors are also patients.
01:13:19.520 --> 01:13:22.159
We also have our own health journeys as well.
01:13:22.239 --> 01:13:27.680
And we all experience the same things with other doctors that that people experience.
01:13:27.840 --> 01:13:35.840
And, you know, I think that it's important to be aware of those things and to understand those blind spots so that we can all try and do better as doctors.
01:13:35.920 --> 01:13:36.239
Yeah.
01:13:36.560 --> 01:13:36.880
As well.
01:13:37.199 --> 01:13:50.239
And as a good counterpoint, it's worth emphasizing that you probably have cases where patients come to you wanting a certain medication and you say, actually, you don't meet the criteria to to get the prescription for this.
01:13:50.479 --> 01:13:50.640
Yeah.
01:13:50.800 --> 01:13:52.720
So I feel like that in itself would be a good counter-argument.
01:13:53.119 --> 01:14:08.079
One of the things that always bugged me about that criticism is let's say someone came to you and they had they were at very high risk of heart disease or type 2 diabetes or whatever example you want to use.
01:14:08.560 --> 01:14:25.199
If you told them that they had to go away and start exercising more, eating more fruits and vegetables, eating more fiber, more protein, fewer added sugars, whatever, if they don't do any of those things and then they die, was it neglectful care not to offer them the simpler out?
01:14:25.359 --> 01:14:29.039
And I know that people will say you shouldn't just push pills on people.
01:14:29.199 --> 01:14:32.000
I'm not saying that that's necessarily what you should do.
01:14:32.159 --> 01:14:42.319
But you also have to understand, or the the listener and the viewer should understand that if you're trying to stop people dying, you can't actually force them to follow certain behaviors.
01:14:42.560 --> 01:14:45.039
So I don't think she'll mind me using this as an example.
01:14:45.119 --> 01:14:49.439
But say my mum, if she goes to the doctor for a health condition and they say, Do you exercise?
01:14:49.600 --> 01:14:50.479
And she's like, No.
01:14:50.640 --> 01:14:51.680
Have you ever exercised?
01:14:51.840 --> 01:14:52.079
No.
01:14:52.239 --> 01:14:52.560
Yeah.
01:14:52.880 --> 01:14:55.279
She's not suddenly going to go to the gym six times a week.
01:14:55.439 --> 01:14:56.640
I would love it if she did.
01:14:57.279 --> 01:15:04.800
But the easiest solution, if it means someone is going to live longer, I feel like it would kind of be silly not to do that.
01:15:05.119 --> 01:15:10.960
And I know that there is a fear of people over-prescribing pills and under-prescribing lifestyle changes.
01:15:11.119 --> 01:15:19.920
But I also think it's very silly for people to condemn doctors for prescribing medication and not focusing on lifestyle when that isn't actually what the doctor is supposed to do.
01:15:20.239 --> 01:15:21.279
And it's a false dichotomy.
01:15:21.439 --> 01:15:22.479
Like, why can't we do both?
01:15:22.640 --> 01:15:29.039
And I think people do get caught up in this either lifestyle change or medicine rhetoric.
01:15:29.199 --> 01:15:34.720
But actually, in the majority of cases, the the both approach is more appropriate.
01:15:34.960 --> 01:15:35.119
Yeah.
01:15:35.439 --> 01:15:37.840
There's a lot of quite binary way of thinking.
01:15:38.560 --> 01:15:39.439
Next criticism.
01:15:39.920 --> 01:15:43.199
Doctors don't actually know anything about fitness and nutrition.
01:15:43.359 --> 01:15:44.159
What say you?
01:15:44.640 --> 01:15:48.319
Um, I say that I think that this is improving.
01:15:48.560 --> 01:15:57.359
I think that, you know, I would say that definitely in at the time when I went to medical school, nutrition training wasn't huge.
01:15:57.600 --> 01:16:07.199
And nutrition training in the hospital context is kind of different to knowledge about how to, you know, how to diet or what we should or shouldn't be eating.
01:16:07.760 --> 01:16:16.319
Um I definitely think doctors don't know very much about fitness, or definitely we're not trained in fitness.
01:16:16.640 --> 01:16:20.560
Um but then again, I don't think that we need to be.
01:16:20.640 --> 01:16:23.439
Um but I think Did you not have a bench pressing module?
01:16:23.760 --> 01:16:26.239
I didn't have a bench pressing module, unfortunately.
01:16:26.560 --> 01:16:41.920
But I I also think it's like I think that sometimes doctors find it hard to stay in their lane because I think sometimes the way that we have historically been educated in medical schools is to believe that we are that we are all knowing and that we know everything.
01:16:42.079 --> 01:16:44.239
Um and I think that has changed quite a lot as well.
01:16:44.319 --> 01:16:56.159
And I kind of consider it as in in my role as a medical educator, I think it's really important to remind us all about our scopes of practice when, you know, when when we are practicing.
01:16:56.399 --> 01:17:04.479
And I think it's very easy, particularly in a um specialty like general practice, where you are talking about people's lives and their livelihoods.
01:17:04.640 --> 01:17:15.520
And, you know, you do end up sometimes straying into the life advice territory when you're having these discussions and you have to occasionally kind of remember, you know, this isn't, you know, this isn't just a normal conversation.
01:17:15.600 --> 01:17:17.359
This is a professional conversation.
01:17:17.520 --> 01:17:23.439
Um, and you should be advising people on what you're qualified to advise them about, not, you know, not other stuff.
01:17:23.680 --> 01:17:26.960
Um, and it can be really easy to start talking about diet.
01:17:27.039 --> 01:17:41.279
And I think, you know, I definitely got when I was going through my my diet stuff and I was losing weight and people were asking me about what I was doing, it was uncomfortable because there were times when I would be talking about things like the paleo diet to patients.
01:17:41.359 --> 01:17:57.439
And when I reflected back on that afterwards, I was like, wow, this is not like once I had kind of realized that the way that I diet isn't, you know, evidence-based or whatever in that situation, and that's a learning process.
01:17:57.520 --> 01:17:57.680
Yeah.
01:17:57.920 --> 01:18:10.159
But when people who are qualified in those things, like personal trainers and nutritionists, tell you the paleo diet is really great and you believe them, and then you pass that information on to patients, it's still your responsibility of what you're passing on.
01:18:10.319 --> 01:18:14.000
So I think it's just really important to just stay in our lanes.
01:18:14.159 --> 01:18:18.960
And that's as important for doctors as it is for every professional professionals.
01:18:19.039 --> 01:18:19.199
Yeah.
01:18:19.600 --> 01:18:34.399
I think the claim that doctors know nothing about nutrition and exercise, I always find kind of funny because I feel like the people who shout at the loudest are often the people who know least about the nutrition advisor.
01:18:34.640 --> 01:18:35.279
The least qualified.
01:18:35.600 --> 01:18:35.920
Exactly.
01:18:36.079 --> 01:18:38.560
So isn't that kind of the Dunning Kruger effect?
01:18:38.640 --> 01:18:38.720
Yeah.
01:18:38.960 --> 01:18:54.399
If a if a fitness influencer, which I appreciate, I'm technically one, but if a fitness influencer is saying you shouldn't listen to your doctor because they don't actually get any nutrition advice, blah, blah, blah, blah, a lot of the time it is packaged because they are about to say some nonsense.
01:18:54.640 --> 01:18:54.960
Absolutely.
01:18:55.199 --> 01:18:59.760
And they are what they actually are trying to do is discredit a doctor.
01:18:59.920 --> 01:19:00.239
Yeah.
01:19:00.479 --> 01:19:06.800
And I have no issues with saying here are things that doctors don't learn in medical school, for example.
01:19:07.039 --> 01:19:19.039
But I also know that the amount of training that you have had, the number of years that you have had, the amount of experience you have had is so far above and beyond what most people on social media have.
01:19:19.279 --> 01:19:33.199
I personally find it really offensive when someone who is entirely unqualified or has very minimal qualifications like a personal trainer is discrediting you because it feels like such a silly direction to punch.
01:19:33.359 --> 01:19:43.359
Rather than just saying doctors are extremely knowledgeable on some things, it doesn't necessarily mean that you want to ask them for dietary advice because that's what registered dietitians are for.
01:19:43.439 --> 01:19:43.680
Yeah.
01:19:43.840 --> 01:19:47.920
But this whole straw man of trying to make it sound like doctors know jack shit.
01:19:48.000 --> 01:19:50.159
Yeah, I just find embarrassing.
01:19:50.399 --> 01:19:51.760
Yeah, I know, I get what you're saying.
01:19:51.840 --> 01:19:57.359
I think, I think it is there is a, there's definitely the kind of it's that anti-intellectualism, isn't it?
01:19:57.520 --> 01:20:01.600
That people just want to kind of believe that you you don't know anything about anything.
01:20:01.680 --> 01:20:04.479
And it does, it does feel like that sometimes.
01:20:04.720 --> 01:20:21.439
Um, but yeah, I think I think we we as doctors can sometimes also be our own worst enemies because we've also seen some really terrible nutritional misinformation online from doctors, but we've also seen really terrible nutritional misinformation online from nutritionists.
01:20:21.600 --> 01:20:24.800
So it's just, I think there's just a lot out there that isn't great.
01:20:24.880 --> 01:20:27.039
And we just need to all work harder to make it better.
01:20:27.119 --> 01:20:27.279
Yeah.
01:20:27.439 --> 01:20:27.840
As we do.
01:20:28.239 --> 01:20:28.720
I agree.
01:20:28.960 --> 01:20:32.720
What do you think are some valid criticisms of doctors and the medical system?
01:20:33.279 --> 01:20:34.000
Oh wow.
01:20:34.239 --> 01:20:41.680
Um I mean, I think the medical system, uh particularly in this country, I can only really comment on it in this country, I guess.
01:20:41.920 --> 01:20:46.079
I think that the system is under-resourced uh and overstretched.
01:20:46.319 --> 01:20:55.680
And I think that there are a lot of people who are trying really hard within a broken system to try and give the best care that they possibly can.
01:20:55.920 --> 01:21:02.640
And it it gets really difficult because the criticisms that people have of that system are really valid.
01:21:03.119 --> 01:21:08.319
And sometimes it can be hard working within that system because you want to do better for people.
01:21:08.399 --> 01:21:08.800
Yeah.
01:21:09.119 --> 01:21:16.319
But the problem isn't always you, but there is always something that you can do to try and help.
01:21:16.479 --> 01:21:20.720
Um and sometimes it works and sometimes it doesn't.
01:21:20.960 --> 01:21:27.840
Um, I think that it's hard again to be critical of doctors as individuals because I don't know them all.
01:21:28.000 --> 01:21:36.159
Um, I know that we, you know, I always try and reflect on my own practice and try and improve in places where I think I might be falling short.
01:21:36.319 --> 01:21:39.279
And I think that's what all doctors should be doing.
01:21:39.520 --> 01:21:55.680
Um, but I think again, having that humility can be really helpful, sometimes realizing that, you know, of course, patients will know a lot more about their own conditions than you might, particularly if they've been living them living with them for a long time, and having that respect and compassion for people.
01:21:56.000 --> 01:22:05.600
That kind of reminds me, going back to the doctors are glorified pill pushers and they don't prescribe lifestyle changes.
01:22:06.159 --> 01:22:08.479
I understand why people have that thought process.
01:22:08.560 --> 01:22:10.159
I do genuinely understand that.
01:22:10.319 --> 01:22:13.680
But I also, one of my best friends, his parents are doctors.
01:22:14.000 --> 01:22:21.760
And I know he said at one point during their busiest practice, his mum had something like an average of four minutes per patient years and years ago.
01:22:22.239 --> 01:22:24.560
So the idea that she's gonna be like, okay, sit down.
01:22:24.640 --> 01:22:26.079
Yeah, talk to me about your diet.
01:22:26.159 --> 01:22:37.680
Yeah, talk to me about like I think there are part of the reason we included this question is because we know that you're very happy to talk about reasons why doctors could fail care or the medical system could fail care.
01:22:37.840 --> 01:22:46.720
But I think it's important that people realize that sometimes it is that there are limitations within the system rather than this is the doctor's fault.
01:22:46.960 --> 01:22:47.119
Yeah.
01:22:47.199 --> 01:22:51.760
And it there's there's so many systemic limitations, whether it's resources, whether it's stigma.
01:22:51.920 --> 01:22:54.800
Like I think we we've talked about weight stigma and stuff before.
01:22:55.039 --> 01:23:00.880
Um, and I guess what we can do in the system is again, that's why education is so important.
01:23:01.039 --> 01:23:11.439
That's why I like having a role in education, because I wasn't taught about weight stigma when I was a medical school or when I was training, but I can make sure that people coming through now are being taught about it.
01:23:11.520 --> 01:23:12.560
And that's really useful.
01:23:12.800 --> 01:23:12.960
Yeah.
01:23:13.119 --> 01:23:13.520
Yeah.
01:23:13.840 --> 01:23:17.439
Do you think social media is a good place to get health and fitness information?
01:23:17.920 --> 01:23:25.119
Um, I think there are good places in social media to get health and fitness information, but I think overall it's sketchy.
01:23:25.279 --> 01:23:31.520
I think, you know, I think if you know what you're looking for and you know who you're getting it from, then I think it can be really helpful.
01:23:31.600 --> 01:23:33.439
And I think it can be really empowering.
01:23:33.840 --> 01:23:39.760
Um, but I think it is also a bit of um, it's like it's shark-infested waters, isn't it?
01:23:40.079 --> 01:23:41.439
It's a bit of the wild, wild west, is what I say.
01:23:42.079 --> 01:23:42.159
Yeah.
01:23:42.319 --> 01:23:43.279
What's happening here?
01:23:43.600 --> 01:23:50.399
Uh, final two questions that we ask all of our guests is what is something that you have changed your mind on?
01:23:50.960 --> 01:23:56.800
Um, I have changed my mind on diet, to be honest.
01:23:57.039 --> 01:23:59.600
And it was so interesting to me.
01:23:59.680 --> 01:24:14.960
I think that's one of the most powerful things in my career was basically getting some objectively non-evidence-based dietary advice from a professional early on in my journey and believing it hook, line, and sinker.
01:24:15.279 --> 01:24:15.439
Yeah.
01:24:15.600 --> 01:24:26.720
Um, being completely dedicated to the fact that the only, the only way to lose weight is to cut out wheat, sugar, and dairy and have a cheat day once a week where you don't have to do that.
01:24:27.039 --> 01:24:41.119
And, you know, I believed it so strongly, despite all of my education and all of my understanding, that it made me, it gave me this sense of total humility that I could be wrong about anything.
01:24:41.359 --> 01:24:51.920
And it's one of the, I think it's, you know, although it was one of the things that risked probably most derailing my relationship with food and all of that sort of stuff, and actually my whole fitness journey.
01:24:52.079 --> 01:25:03.920
I think it's one of the things that I'm happiest about happening because it gave me an insight into, well, if I can be duped by all this stuff, then imagine the people who haven't been to medical school and haven't learned all this stuff.
01:25:04.079 --> 01:25:11.119
Um, and it it helped me to be more compassionate about people who don't know the evidence-based stuff and to try and help them to understand it.
01:25:11.439 --> 01:25:12.479
Yeah, that's a great answer.
01:25:12.720 --> 01:25:12.880
Thanks.
01:25:13.199 --> 01:25:14.079
Final question for you.
01:25:14.239 --> 01:25:16.560
What is a hill you're willing to die on?
01:25:23.199 --> 01:25:24.720
The hill I'm willing to die on.
01:25:29.680 --> 01:25:48.159
Um I just think that in health and fitness, and I don't think this is gonna come as a great surprise to you guys, because I think this is something that you have always preached, but the overfocus that we have on weight loss at any cost is too heavy.
01:25:48.399 --> 01:25:50.000
And pardon the pen.
01:25:52.800 --> 01:26:05.439
And I just the hill I'm willing to die on is that we should always focus heavily on health behaviors, not on health outcomes.
01:26:05.680 --> 01:26:12.399
And we should be encouraging people to improve their health behaviors, not to lose weight, for example.
01:26:12.720 --> 01:26:12.960
Yeah.
01:26:13.119 --> 01:26:14.479
That is a hard cosign from us.
01:26:14.800 --> 01:26:15.520
Very hard cosign.
01:26:15.840 --> 01:26:16.399
I thought it might be.
01:26:16.640 --> 01:26:16.880
Dr.
01:26:16.960 --> 01:26:21.199
Mike, we've had so many valuable mic drops from you today.
01:26:22.239 --> 01:26:23.600
I'm sad I blasted that.
01:26:24.000 --> 01:26:28.319
I'm so happy that we could have you on our podcast, even if you wouldn't travel to see us in California.
01:26:28.960 --> 01:26:31.680
Because you're a great friend, but apparently not that great.
01:26:32.800 --> 01:26:38.159
You know that this week I was going to message you and be like, I believe it.
01:26:38.560 --> 01:26:39.039
This is true.
01:26:39.199 --> 01:26:39.680
This is true.
01:26:39.760 --> 01:26:41.199
I was like, I've got that week off.
01:26:41.359 --> 01:26:44.239
I wonder if Ben and Sohi are free and I could go visit them.
01:26:44.560 --> 01:26:45.199
And then literally.
01:26:45.840 --> 01:26:46.560
Let's talk about this after.
01:26:46.880 --> 01:26:50.159
Exactly, because Ben messaged me and was like, what are you doing this week?
01:26:50.239 --> 01:26:51.600
We're gonna be in England.
01:26:51.760 --> 01:26:52.800
And I was like, I'm free.
01:26:52.960 --> 01:26:53.520
I'll see ya.
01:26:53.760 --> 01:26:58.640
Coincidental that he claimed he was free after I told him the dates and said we were going to be in London.
01:26:58.880 --> 01:27:00.880
Anyway, today has been a pleasure.
01:27:01.119 --> 01:27:06.960
I am always excited to talk about mental health, but especially excited to talk with one of our closest friends.
01:27:07.439 --> 01:27:09.760
And we hope that everyone has enjoyed it as much as we have.
01:27:10.000 --> 01:27:10.800
Thank you for having me.
01:27:11.039 --> 01:27:11.520
Thanks so much.
01:27:11.680 --> 01:27:12.880
Air High Five.