Optimal Health and Healthy Thinking with Guest Dr. Shahana Alibhai

Serena: Hey Everyone, I’m Serena.

Tina: And I’m Tina and we are the Mental Health Mamas.

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Serena: Welcome to No Need to Explain, we are so glad you’re here.

Tina: First, as always, a quick disclaimer.

Serena: We come to you NOT as mental health professionals or experts in the field, but rather as the parents of kids who struggle with their emotional health.

Tina: If you or someone you love is experiencing a mental health crisis, please seek professional support. You’ll find a variety of resources in our show notes and on our website, NoNeedToExplainPodcast.com.

Serena: One of the missions of our podcast has been about normalizing the conversation around mental health. We’ve really tried to do this in every single episode and talk about the idea that we all have mental health just like physical health.

Tina: Right. According to the National Alliance on Mental Illness (or NAMI), 21% of adults in the United States experienced mental illness in 2020. That’s the 1 in 5 statistic we’ve shared many times before. What’s important to know is that while there are certain demographics that are more affected than others, there is no group or identity of individuals that is not affected.

Serena: Right. Exactly. This is ALL of us. We have a guest joining us today who is an expert by experience as well as a content expert on health and wellness.

Tina: Dr. Shahana Alibhai is a professional speaker, a practicing family physician and the mother of three young boys. Shahana, welcome to the podcast!

Shahana: Thanks so much for having me! I’m so excited to dive into this topic.

Serena: OK. So, Shahana, you’re joining us from British Columbia and I’m wondering if you happen to know the mental health statistics for Canada. I’m wondering if it’s similar to what we just shared for the United States?

Shahana: Well, in fact, it’s exactly the same. It still is that one in five or about 20 percent of the population that will experience a mental illness or a mental health issue at some point in their life. If we look at the Canadian population right now, you can think of it as about six percent are currently suffering from a substance use issue, five percent from depression and just a little bit under that, 4.6 percent with anxiety. So these are striking statistics and then you think about the teenage population which is what I work with and that statistic still proves true. Twenty percent of young adults are suffering from some kind of mental health illness but, this is the caveat, only one in five youngsters, only one in five kids or teenagers are receiving the appropriate mental health treatment. So for me, that is where I and my colleagues and this effort to increase conversations around youth mental health have to be more at the forefront.

Tina: Yeah, that’s a pretty striking statistic I would say and a bit consistent with something we’ve quoted in the past, right Serena? That 11 years passes before…from the onset of mental health symptoms to the seeking of treatment which is…11 years? That’s just staggering. So, we will definitely talk about your professional work as a physician and a speaker, but first we would love for you to share a little bit of your personal story with our listeners.

Shahana: Of course. I’d be happy to. And I think it’s my personal story that gives the context of perhaps why I’m so passionate about speaking on this topic because unless you’ve walked this road, unless you’ve faced the stigma, unless you’ve felt the shame, it’s hard really now to come on the other side and to talk to those who are going through it and meet them in the eye and feel like, I get it. I know what that feeling is.

So for me, I guess if you just take it a little bit farther back. You know I always grew up with a lot of perfectionistic tendencies. It wasn’t induced by my parents at all. It was just…I think it was a lot about feeling safe in the identity of academics. So by that I mean, if I felt like I was smart, if I felt like I was the top of the class, then the transactional nature of that was that you must like me, right? My identity solidified in my grades because it was just basically a signpost of me realizing how insecure I was in other areas of my life. So the more I could appear with their tests or their exams, the better my grades were, the more confident I felt and I got known as the “smart kid” or the “smartest kid”. But guess what? It’s extremely lonely being that role because nobody wanted to be friends with me because all I did was study or continue that pursuit. It wasn’t until the day that I graduated that whom I thought was my best friend, the one of one I would say, came up to me and said, “Well, the only reason I’ve been your friend this whole time was so I could cheat off you.”

Serena: Oh!

Tina: Ooo, gosh.

Shahana: So therein solidified more that I better just keep doing this because I had nothing else to offer so I’m just gonna be the smart kid. And when you’re the smart kid, you know, medicine tends to be what everybody kind of preaches around you but I didn’t want to go into medicine. I really wanted to do something…it’s actually funny. I injured my knee when I was a teenager. I went to see a physiotherapist and I’m going, “Oh my word! You can heal me just through the power of exercise?” Like, I grew up in a family of pharmacists. So for us there was a drug for everything we need. Not in a bad way, but that was just kind of how it was. So here I’m going, “This is really cool, like we talked about. The body is incredible.” So my plan and my path was to pursue something in physical medicine whether it be chiropractic or physio. So I started off in Kinesiology but very soon did I realize that I loved the science and the knowledge. It was the manual treatment with my hands that I was abysmal at. So I was great at talking to people about their pain but treating people was another story. So unless there was a profession called, Physio Psychiatry, I wouldn’t have made much of a living there.

So I quickly pivoted to medicine simply because it was the content. I knew that I loved talking to people and studying about the human body but the wellness piece was just missing. Let’s be honest. In medicine, all you’re taught is disease.

Tina: Yeah.

Shahana: So I hated that. You know, everything is even incentivized in the pay system about the sicker the patient, the more remuneration you’re going to get. After I finished medicine, which is a wonderful distraction from anxiety because basically all you have is head under the sand, trying to survive. And unbeknownst to me when I entered medical school, I was surrounded by people who got through life the same way. By leading with their academic foot, right? So suddenly, in some ways I wasn’t alone but in some ways like breeds like and that wasn’t a good kind of like if you know what I mean, right? Because you’re surrounded by people who now are quite competitive and there’s only one spot for number one but you have 250 people competing for that spot.

Serena: Right.

Shahana: However, I quickly made my peace with all of that because the one desire I had carried in my heart this entire time was that I just can’t wait to be a Mum. And if you asked even my friends in medical school, that’s all I talked about. Some people wanted to specialize in Dermatology, others in Orthopedics. Me was in Motherhood. That was going to be my specialty. So my friends got to a point going, oh my word, will you just stop talking about it already? But I think I had this vision of Motherhood where I will strap on an apron, I will have this lovely baby, we’ll be at home, we’ll be bonding and guess what? I might have a little bit of a break. A break from this hamster wheel. A socially acceptable break, right? Because Motherhood is productive or seems to be or I thought it was. Or at least you can tell people, oh I’m having a baby. Oh OK, so she’s busy doing something that’s socially acceptable. So of course you don’t know all these thoughts when you’re going through it. You just think, your mind is kind of laser focused on one thing so of course when that day came after residency that my husband and I were successfully able to get pregnant, I felt that I had won the lottery. I thought, forget medicine, this is my identity now. Now I’m not the Dr. Shahana, I’m the Mom Shahana. I’m going to own this role and I did from the moment I found out I was pregnant. I started clutching my stomach before there was nothing even showing there because that was the role I was going to play. And I think when you put something on such a pedestal, you have that much farther to fall. And that’s exactly what I did because now, as I know all too well, Motherhood is beautiful but it’s painful. It’s perfect and it’s completely imperfect. And there is nothing more fertile than Motherhood to bring in and back everything that you haven’t dealt with in your life.

Tina: Wow.

Shahana: Anything that you’ve tried to sweep under the rug. Guess what’s going to pop its ugly head? You know those Whack-a-mole games. You feel like you’re kind of beating it down, but motherhood, all of those guys pop their head up. And for me, the thing that I had suppressed for so long, the thing that I had lived in shame for so long was that I had a very…not a rare, but a much less common subtype of OCD called Pure Obsessional OCD. And even saying those words, let’s be honest, it’s a lot easier to admit to somebody that I have anxiety or depression. The minute you’re talking about other things like OCD, psychosis, schizophrenia, bi-polar; these are all what I would call the heavier mental health issues. The ones that cause us to pause and maybe swallow a bit because that stigma can feel so much more sharp and it certainly did for me. So I didn’t know I had pure obsessional OCD. I just thought I had a “thing” ever since the age of five. I knew something wasn’t quite right. I talked to my Mum, you know, this was 30 years ago. She didn’t know what to do. She did the best thing she could at the time which was comfort me and provide me different techniques. But it wasn’t until medical school that a slide flashed before me and a little line underneath the slide of OCD that said, “subtype: Pure Obsessional” where you don’t have the compulsions so nobody can recognize it but you have an obsessional thought that is extremely distressing to you. So lo and behost to me, the obsessional thought when the baby came along which is a very common obsessional thought but very, very difficult to talk about was, could I cause harm to my baby? And I say this because it took me to the point of not wanting to be here any more as a health care professional, as someone who studied this, as someone who’s mentored other residents about this, but I didn’t…I might have recognized it within myself but I wasn’t prepared to let go of my cloak of ego. I just couldn’t. I couldn’t. Because that was my safety net, right? So the minute I had to tell somebody that I was having these thoughts, I A. thought, OK, they’re going to take the baby away because that’s what happens. That’s what happens.

Tina: Yeah, yeah.

Shahana: Right. Or B. They’re going to just, you know, put me away. Not that I knew where “away” was, but you know you think about these sorts of things because I was stepping out of the safety of my academic lens into this world of a patient. And now I know the world of a patient is vulnerable. You are on your knees because you know you need help, but you’re almost so afraid to admit anything because I don’t know what the repercussions of me asking for help is going to be. So it was a year. It was almost a year after my eldest son was born and it was turmoil in that time. It was, you know, it was trying everything. Burying my head in the sand pretending that this wasn’t here. It was trying to meditate my way out of it, trying to exercise my way out of it, gulp fish oil out of it. You know, those are all great at bolstering you but when you are on your knees, you need something to help pick you up.

Tina: Mmhm.

Shahana: Calling the physician healthline, the anonymous physician healthline, was my rock bottom and was my turning point. And it was the time that I said, “I need help.”

Tina: Yeah. Yeah and I think during, honestly, during the pandemic, physicians struggled with that, right? Because to admit that you needed mental health support during a time when you are just supposed to be physically giving everything else to everyone else, right? There have been a lot of struggles with that, including, I think we’ve just had a Federal bill passed in the US. A physician who ended her life and it’s to help support mental health in physicians. So it’s a vulnerability. You’re exactly right. It’s a vulnerability and you’re supposed to be the smart one. You’re supposed to be that one that helps everyone else, right? But the fact is that has certainly come to light even more with the pandemic. So, yeah. Thank you for sharing all that.

Serena: Mmhm.

Shahana: My pleasure.

Serena: Yeah. Yeah, I was gonna say the same thing. I appreciate your vulnerability and your willingness to talk about these things that we know affect so many people and it is super hard to, to bring these things up. But I’m gonna shift gears for just a little bit here and talk about something a little bit different. As we were preparing for this episode we were talking about our different healthcare systems. The healthcare system in Canada versus the United States and I think that many of us living here in the US, we have a sense that healthcare is so much better in Canada (and maybe that the grass is a little greener too across the border). But I’m wondering…you can debunk that if you want or agree but tell us about some of the challenges that you face as a physician working in Canada?

Shahana: Yeah, that’s a…I loved having that conversation previously because I think it opens my eyes. You know, when you’re in it, sometimes you don’t understand…all you have is maybe criticism for your own what you have versus maybe appreciating what you have. But let me start by saying, you know, free is not necessarily better and free is not necessarily effective. So in terms of a recent health study that was done, they looked at a bunch of different countries and health inequities and just overall measurements of the healthcare system and it was Canada and the US that were basically placed at the bottom with the states being quite a lot lower than Canada but Canada was still at the bottom as well. So it just shows you that we have a lot to learn from countries, especially the Netherlands and countries in that region who are doing a much better job in terms of getting some of those healthcare systems and inequities more normalized. But I think if we think about healthcare, what do you want in a healthcare system? You want it to be effective. You want it to be timely. You want it to be efficient. And you want it to be equitable. Like if we have basically a crystal ball and say, like, this is what I want in the future of my healthcare system, those would be some pretty darn good things to label your healthcare system with. And although Canada, yes, it’s quote unquote free because it’s through our taxpayer’s money, you have to realize that every province and every territory in Canada, so 13 in total. 10 provinces and 3 territories all have a different healthcare system. So you can’t go province to province, I mean, for the most part it’s the same but there certainly are differences depending on where you are. So that’s important to keep in mind.

Where I feel the burn of this a lot, and one of my jobs in addition to working with youth, is that I am one of the lead physicians at the Breast Health Clinic. So we are the first to see and diagnose any sort of breast-related complaint for women and sometimes men in the Fraser Valley. So this kind of area that I’m living in. And it’s a very common scenario now where I’ll see a woman who has had an abnormality on her mammogram, though it’s marked as relatively low suspicion, but we don’t know for sure. I’ll do a clinical breast exam. Everything seems ok and just to give you an idea, for her to have peace of mind right now, she has to wait until mid-February to get that ultrasound.

Tina: Oh geeze.

Shahana: So can you imagine for a second, and this is one of the parts of my job I absolutely detest because I even tell them. I say, you know, clinical breast exam is OK, but it’s not the best. A mammogram is good but there’s flaws in it. Even an ultrasound. So you need…that’s the whole point of breast health is that you need all three together. And I can do my best but I don’t have ultrasound hands. I certainly can’t so if that was me or that was a close family member, I would feel very uneasy saying, oh just wait a couple of months and let’s hope for the best that your ultrasound is OK. So timely. Timely is a huge thing. There have been people waiting for surgeries, not life-saving surgeries, but certainly knee replacements, hip replacements, an extraordinary amount of time, especially because of COVID. And we know how much that affects your day-to-day life, your quality of life. You know, it’s not just about the need. It’s about your pain, how you’re sleeping, how you’re interacting, how you’re contributing to the workforce. So the timeliness of our healthcare system is definitely taking a hit.

You know when we think about the effectiveness as well, I have…I come from a family as well. My husband’s a chiropractor, my sister is a naturopath. I strongly believe that there is a role for the allied healthcare professional in enhancing somebody’s life but here we work in silos. It’s actually very frowned upon to be seeing somebody, you know, outside the, what I would call, conventional medicine system. And I have a lot of patients who say, “Oh, I’m actually seeing a Naturopath.” I’m like, tell me. We need to be communicating with each other.

Tina: Yeah. It’s not a dirty secret.

Shahana: No. I’m not going to get offended.

Tina: But that is how it is here as well.

Shahana: Oh!

Tina: There’s no coordination of care with people who don’t have medical degrees, right? So like the chiropractor and the acupuncturist. None of those people communicate. The, you know, the herbalist, the people…and I see all those people but my doctor does not necessarily…yeah, you know, yeah.

Shahana: This is what I encourage. I think by leading with the fact that I’m married to a chiropractor and my sister is a naturopath and phenomenally smart and intelligent. She’s a pharmacist herself and she only went into the career because of her own health challenges knowing how as a pharmacist, you need both. And I think people always come…even when I was going through my mental health issues, yes I got started on medication. I would never say…that was a huge stigma as well, but yeah, you do it when you have to do it. Did I try to support my health in other ways? Absolutely. So this collaboration of care is difficult and it’s difficult for many reasons and it always comes down to economics or money at the end of the day too. So I think that’s a big thing as well and I think being equitable, being…right now so many youth I see and they come in with so much pain because they’re working hard in construction or various jobs and I look at them, I would love for them to go to massage or physio or chiro. Do you think they have the money to spend 80 dollars for an appointment?

Tina: No.

Shahana: Absolutely not. So now what? I’m gonna prescribe them Naproxen or some anti-inflammatory? That doesn’t sit well with me.

Serena: Right.

Shahana: So I’ve started carrying these, you know, lacrosse balls because basically you can do some kind of trigger point stretches with them so I carry a whole stack of lacrosse balls with me at my clinic and I show them the various stretches. Because, I’m like, if I can, if we can treat this at the source, it comes back to my initial passion of using exercise for good and to get away from medication and why not? But it’s almost like, for me, people look at me really odd because that’s not what a doctor is supposed to do, right? So those are just a couple of the ways that I personally can experience the inequities in our healthcare system.

Tina: Yeah, so you’ve talked a little bit about what you might do and we’re curious, if you would weigh in a little bit on the mental health part of that. So if you had the power to change the healthcare system, it sounds like you would break down those silos but what about in supporting people’s health and wellbeing? Are there particular things that you would do to change the way things are?

Shahana: Such a good question. You know, number one, bolded, underlined would be universal psychotherapy.

Serena: Mmhm

Shahana: Absolutely. Like this is…forget a universal drug coverage plan, we need better, more timely, free or subsidized access to counselors. And yes they are trying. They are trying to have some of these programs but those programs are just inundated because of the need. Sometimes because of that, the quality can go down or they’re trying to serve people in a group matter or just doing the best they can but we know outcomes for depression can be staggeringly better if someone was given one-on-one psychotherapy. Almost as good for mild and moderate depression as a medication. But we also know that asking people to pay out of pocket is extremely difficult and you add in COVID and the economic burdens that people are already carrying. That’s just not gonna happen. So and I think what we fail to realize is that we always wait until the diagnosis. Oh, you need to be diagnosed with depression. Like, what about preventative psychotherapy?

Serena: Right.

Tina: Yeah, right.

Shahana: What about…that is one treatment or one skill I believe all of us should be engaging with it more. Dare I say mandated to have something where people have the leniency to know, oh my word, this is a really powerful thing that I can do is to…because we know rates of loneliness are so incredibly high. People used to have friends or family that they can talk to. Now people are lonelier than ever and more isolated than ever. Where does that lead you? So that mental health support in the form of psychotherapy would be number one for me. And then number two is, you know, I can speak to Canada, but I know here in British Columbia there’s not a shortage of resources, there is a difficulty accessing resources. There is a big difference there.

So we know that 40 to 80 percent of what I tell a patient in the encounter will be forgotten by the time they sit in their car. Like, that is a staggering amount. And we expect the elderly, we expect our youth, we expect our vulnerable populations to come in, you know, we dump out everything we think at them and then say, ok we’ll see you in a follow up. And they’re leaving and they’re like, what did they just say? What's happening?

Tina: Yeah, right.

Shahana: So for me it’s who or how could we connect the dots between the vulnerable patient experience and sometimes the myriad of resources that are out there. And at our clinic, we’re fortunate to have this for the youth that are called Navigators. It is exactly this. Somebody…half the time when I’m seeing a youth it has nothing to do with a medical problem but it’s everything to do with a social issue.

Serena: Mmhm.

Shahana: So I will task one of the Navigators and say, look, I have a parent of a teen who is really struggling right now. Can you please look up parent support groups, talk to this parent and touch base with them, and give them those resources? Like a warm handoff.

Tina: Love that.

Shahana: Because I’m not…there’s just no other way. So the next time I see the parent, I can check in. Did you get some of those resources? How did that work out for you? Because you have that warm body who is actually doing this navigation for between the doctor and the patient. So we call it Navigators, Patient Advocacy Workers. I think Social Workers end up bearing a big brunt of this but they are overworked as it is. So I think one of the most important roles in our healthcare system is that of the Social Worker because they act very much like a Navigator in our healthcare system. But we need more of it and more people need access to it to bridge the gap.

Tina: Mmm.

Serena: Yeah. Absolutely. Yeah, we are…we are right there with you. You know, the silos, the support. The support is huge, right? Supporting parents.

Tina: And I think I want you as my doctor. Because you are doing all the things, right? Just a little commute for me, right?

Shahana: Yeah, yeah yeah.

Serena: Yeah, so we would like to talk about something you’ve developed which is a Pyramid of Optimal Health. We would love for you to share what this is with our listeners.

Shahana: Of course. So for those of you who can jump online later, just visit my website, drshahana.com and you’ll see it right there. The Pyramid of Optimal Health was literally born on the back of a paper napkin. That’s what it’s origins was because one day, and this was after I had been on medication, after I had seen psychiatry, after I had felt like I was going to do everything that I promised myself I would never do, which were those two things and I thought, OK, here I am. I’ve spent all of this time in medical school. I spent a degree studying the body. I thought I knew about nutrition. Where…like, what am I missing here? Why is this so hard for me? And then I realized that I was doing everything but addressing probably the most important piece of all of this which was my brain or the mind or whatever you want to call it. And that’s why the foundation of the pyramid is Train Your Brain. Think better. Think better. And I kept it really simple because the purpose of this pyramid is that if you can at least keep each element of this pyramid in your mind, I don’t see why you will not lead a more content life. Like, I really can make that as a promise to you. Because if you think about it, on the base of this pyramid is the thinking better. Mental health is not a destination. We all know that. It’s not like, oh, finally I am home at my happy mental health. It doesn’t happen, never will happen. Every day, every second, every minute is a little bit different. But it’s…I never learned how to think. I knew how to study. I knew how to regurgitate information on an exam, I was great at that. But I never knew that my mind would help me or hinder me in terms of what I was thinking. And a lot of that has to do with the story that we’re telling ourselves. You know my favorite story these days is I am the overworked, stressed, overwhelmed Mum. That is my story and I live there. A lot of the time. I probably lived there this morning when I was trying to get my two kids out of the house to make it in time for this podcast. My four-year-old is lying on the ground, kicking and screaming and not putting his socks on because they’re too bumpy. Like, you know, and in your head, you’re like, oh, I feel sorry for you Shahana. You have so much on your plate. Like, you know? It’s the pity party. But I never recognized the pity party. I never recognized my sympathy story. And you know what the purpose of that story is? Guess what? It’s to give me significance. It’s for somebody to put a flashlight on me and say, oh, you’re such a good Mum, right? That’s what it is. It sounds…it’s hard for me to admit that. It’s for me to admit that that’s what is at the depth of my story but that’s what it is. And I think the minute I realized that I can dig deeper into that voice, into that story that I’m telling myself and at the core I will find the thing that I am lacking or the thing that I am most scared about. And the thing that I’m most scared about is failing as a Mum. So I want everyone around me to bolster me and surround me with feelings of, you are amazing. And don’t you see it all the time in Instagram and Facebook? All of us are struggling with the same thing. We all do it. Nobody calls it out though, right?

Tina: Right.

Shahana: So this is…I never got that. I never…I wish someone had told me about the concept of you have an inner roommate. It’s called the voice in your head that’s always chatting at you and will never leave you alone. That’s a thing, you know? We don’t learn this until…I didn’t learn this until my thirties so that’s why for me everything was…it has to. It has to come down to training your brain to thinking better. But right above that was Connecting Deeply because, let me tell you, if you’re in a toxic relationship, whether it be with your parents, even your kids, your spouse, your friends, whoever it might be, it’s very hard to self-talk your way out of that because I call those your energy vampires, right? They’re there waiting. So finding people you can connect truly with, that you can be yourself with and for me that’s taken 35 years of my life to be…I don’t need to be smart to be loved. I don’t need to be a doctor to be loved. I don’t need to be a Mum to be loved. I can just be me and that’s hard to say.

Serena: Yeah.

Tina: Mmhm.

Shahana: That’s like standing there naked in front of somebody and going, oh, is that OK? Like, you know? That’s hard. That’s hard. So, I don’t know. So that’s why I found…this is me. Everybody might come up with something that works for them. I hope you can see some value in the pyramid. And the middle of the pyramid is where I spent my life. I spent my life eating better, moving more, and the last piece was resting smart. But I lived in the arena of, OK, I can just exercise and eat my way out of any mental health issue. And guess what? It’s a great support but it doesn’t, it doesn’t solve your issue. And I put “Rest Smart” in the midpoint of the pyramid because so much of our day now, we're busy, right? We’re busy in our mind, in our heads. I am a podcast junkie. I love your guys’ podcast. I love listening to podcasts. But I realized the other day that on my incessant drives back and forth to pick up my kids, I am never quiet. And actually, can I admit something? I’m kind of scared of being quiet. I am. I am.

Tina: I think a lot of people fear that, for sure.

Shahana: Yeah. I…it’s hard for me to admit that but somehow in my mind, busyness is productive. Quiet means that I’m not even seizing that opportunity to think about something, to plan something. Like I always say, Mum has a thousand browser windows open in her head. I just feel like I’m doing that little spinny wheel of death always. You know that little rainbow circle?

Tina: Yep. We know that. We know that. Yes, we do.

Shahana: I’m like, that’s my brain constantly. Sometimes it just freezes. So I think, forget the meditation, the point right now is quiet and aiming for small periods even if it’s traffic light to traffic light of can I just be quiet. How does that feel in my body? And it feels…it’s hard. It feels weird. I’ll be the first to admit that.

On the very top of the pyramid is your impact, your purpose. This feeling of…that makes us feel alive. It’s why I’m sure you guys do this podcast, it’s why I speak, it’s why I speak so passionately about this. It’s…I will end this podcast and continue to have OCD. That’s not going away anywhere. But me feeling like I might help another woman or man or child or teenager who’s struggling right now, that’s my purpose. Just like I’m sure it is your guys’ purpose too. And that’s what I ask my youth all the time, especially when we’re stuck in that kind of awkward conversation between doctor and patient, you’re going, alright, where are we gonna go from here? I’ll often ask them, like, where…what do you want to do when you’ve graduated, when this is all said and done? And 95 percent of my patients will look at me and say, I know what I want to do. I want to be a “this” and I want to be a “that”. I love that age because they’re 15, 16; they still dream, you know? We’ve just stopped dreaming and they still have that in them. They still know how they are gonna impact this world despite all the challenges they’ve been through. So, for me that’s at the top, but I think it’s circling through it and finding out where your gaps are. For those of you…I’ve created a little quiz. You can take the quiz on my website. You can find out where you rate in the pyramid. And like I said, it’s a constant work in progress but I hope you’ll find it helpful as a graphic representation of life.

Tina: Yeah. And we’ll make sure to include the links so that people can go to your website and explore your pyramid. Yeah, for sure. So, several times you’ve brought up your three young boys and how they are kind of the center of your world, truly. So you’re also a busy doctor, you pursue these speaking opportunities, you’re finding purpose, you’re listening sometimes to the voices in your head and sometimes not. And I hear you on that. So it’s a lot, right? Moms have a lot. Tell us how you take good care of yourself and maintain your own health and wellbeing.

Shahana: Yeah, such a good question and I have to…there might be a long pause here because that might be me taking a micro-nap as I think about this. I need to think about the answer to this too. You know it’s so easy to give, like, the stereotypical answers like I meditate in the morning and I do yoga. Like, you know what? On a good day, maybe. And a good day might be, you know, ten percent of the time. But let’s be honest. When you have young kids, every day is a very, very different day. My kids are 2, 4, and 6. They’re all boys. They are rambunctious. They have no clue for the idea of safety. Every day I feel like today maybe we’re going to the emergency room. This is the day. You know? So it’s, it is…yeah. It’s absolutely exhausting but one of the concepts that I once heard that really stuck with me is that, what if we were to pause and think about self-care as others-care. Like, what if we changed the framework so it’s not self-care, it’s others-care. What if it meant that you could surround yourself with somebody or some people that valued your self-care so much that they made it a priority. Like, what would that look like? And who would you look at to provide you that? And I have to be honest. My husband is that for me. He gives me that space. He maybe knows when I need the space. But he will…I think you need to do this right now. I think you…maybe you’ll…for awhile he used to bring me tea in bed and put on Headspace meditation and I admittingly used to sleep for an extra 10 minutes and then say, oh, that was an amazing meditation. But I think it’s the act of…oh, I can see how much they want this for me or I can see how much that they value this in me so it’s been a work in progress but I’ve tried. Even five minutes of breathing, ten minutes of meditation in the morning with his help has been a huge change for me. One of the big things I’ve learned about myself too is that as a Mum, I never experienced the sensation of wanting to escape so badly before. You know, I think when you’re a Mum, especially a Mum of multiple littles, you realize that there’s something in you sometimes that you just want to flee because it can be so incredibly overwhelming. And I find myself sometimes, after they’re put to bed, just wanting to do anything to mentally escape whether it be looking at Instagram, watching a talk show, like anything like that. And it’s OK to do that but the one nuance that I’ve made, the one change is I ask myself, are you trying to numb it right now? Just ask yourself. If you are, great. But go into that activity with just a sliver of intention. OK, I’m doing this to escape. Because, guess what? When you do that, you don’t need that activity for as long. And the hour hasn’t gone by of you watching cat videos on YouTube and you going, what just happened, you know? I’m me, setting a little bit of that intention, oh yeah, it’s OK to escape Shahana. You can numb yourself for a little bit. That’s OK. But just know why you’re doing it, and maybe how long you’re doing it for.

And the last piece I’ve found very helpful for me is that, find that thing that you lose a sense of time in. You know, you don’t need to be sitting in a lotus position meditating to lose time. You can lose time in art. You can lose time in reading. For me it’s cooking. Cooking is my moving meditation. It’s like an itch within me that, you know if someone…our babysitter that comes sometimes, she’ll look at me, and she’ll go, oh, are you OK? Because I’ve got pots and pans everywhere. Like the more anxious I am, the more, you know, stuff is everywhere. That for me fills my soul. It’s the process of taking something from start to end. I don’t know what it is about it but it makes me go into almost a trance. So I think finding that thing and as a Mum, finding time can be very hard to do but if you can find just an essence of that thing where time stands still, it will make whatever time you spend on that so much more powerful.

Serena: Mmm. Yeah, I love that. Thank you. So for our listeners out there who would like to connect with you and learn more about your work, you’ve mentioned your website which you can say again here and how else? How else might people connect with you?

Shahana: Yeah, sure! So the website: drshahana.com You can sign up for my email list. Take the quiz. And then on Instagram which I’m completely new to but I’m navigating the world, finally, of social media. So thedrshahana. Please send me a DM there. I would love to hear from you. And just appreciate you listening and being along on this journey.

Tina: Awesome! One more question for you today. We’ve talked a lot about tons of different things. We have covered a lot of bases, imagining a better healthcare system to mental health statistics and I really get the sense that the work you’re doing now focused on optimal wellness is really driven by your own personal experience. So knowing your own hesitation to seek help, what advice do you have for anyone out there who might be struggling to get that help?

Shahana: That’s a really, really good question. I think…and I came at it from such a different viewpoint, especially as a physician. But let me tell you this. I think the thing that I was most fearful of is that when I would share my story, I would feel this sense of alienation. That I would be looked upon almost as a creature that was no longer human in some ways. And it was exactly the opposite of that. I finally decided to tell a friend and a close colleague shortly after I got put on medication and I just looked at her and we were working together and I said, look, I’ve started this medication and I’m scared. And up until that point I kind of portrayed myself as the Mom who had it all together and she looked at me and she’s like, you know what? Me too. Me too. I’ve walked that road. You know, she had three kids herself. She’s like it’s the hardest thing. I’m right there with you. So even if you don’t have the wherewithal or the headspace right now to seek professional advice (although I would definitely encourage you to do that because you’ll be surprised). I’m sure you’ll be met with that same kind of empathy. At least, I really hope so. But please, if you have a close friend or family, try it. Try it. Because anxiety loves to breed in silence. At least mine did. And it festers and it grows. And the ugly monster that is anxiety or depression lives in the dark and the minute you shed any light on it, suddenly it’s not so scary any more. So I think you’ll be surprised that you’ll end up hearing that, “me too” a lot more.

Serena: Yeah. I would say that that is our experience and yeah, thank you. Thank you so much Shahana, for joining us today and helping us to continue normalizing the conversation around mental health. And we do hope that you will continue sharing your story with the world because we know it does make it easier for others to do the same.

Shahana: Thank you so much and continue doing the great work you guys are doing.

Tina: Thank you. So podcast friends, we are, as always, grateful for all of you listening and supporting us. You can help us out by visiting Apple podcasts, leaving us a review, subscribing and please share with others. You will find more content on our website, NoNeedtoExplainPodcast.com. You will also find an email address and just like Shahana, we would love to hear from you by email.

Serena: And this is your gentle reminder to take good care of yourself while you are also taking care of your people.

Tina: Thanks again for listening!

Serena: Bye!

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