A male patient is talking to a female health professional. The health professional is taking notes in a notebook.

The top questions I’m asked as a mental health doctor right now

Dr Kieran Kennedy is a Medical Doctor and Psychiatry Resident with degrees in Psychology, Physiology and Medicine/Surgery. He is a respected health and wellness advocate who holds a passion for furthering the mental and physical health of the modern man and woman.

It’s no surprise the events of recent years have massively impacted Australia’s mental health. From the bush fires, to COVID-19, to eternal lock downs and the roller coaster that was the US election, it’s safe to say it’s been one wild ride. 

While it’s been incredibly difficult for many of us dealing with the changes that this year has brought, a true positive has been the shift we’ve seen toward looking ‘inside’ so much more – to having more open conversations about mental health and the place health of mind has in our day-to-day lives.  

Being a medical doctor working in psychiatry in Melbourne, I’ve truly seen firsthand the impact COVID-19 and other recent events have had on the minds of many, and I can’t stress enough that if you’ve found yourself struggling, you’re not alone. 

It’s been a time for reaching out and asking questions. Here are some of the top mental health questions I’ve been asked recently – chances are you might have asked some of these yourself…

How do I know if I’m feeling stress or anxiety?

This is one of the most common questions about mental health – it can be hard to untangle these symptoms. Usually, stress is a response to something external that we are experiencing; a direct ‘fight or flight’ response defined as occurring when we feel our capacity to meet a demand is outweighed by the demand itself. Signs of stress are much the same as anxiety, and we might notice our muscles tense, our breathing quicken, our mind fog or our heart start to race. The difference here however is that stress is usually tethered to a specific demand, and eases as we tackle it. 

An anxiety disorder however encompasses symptoms that tend to stick around after the stressful situation has passed or resolved – or without one being there at all. Panic attacks, restlessness, racing heart, obsessive thinking and hot and cold flushes are all symptoms you might be familiar with. If signs or symptoms of stress or anxiety are gearing up to significantly impact our day to day lives, or look to be lasting far longer than we think they should, then it’s important to head to your doctor to get some support. 

Is it normal to have mood swings?

In a word, yes. Changes in our mood and quick shifts in emotion are common, and not necessarily a sign of illness or disorder. This one has been a hot topic lately and an important one to clarify and call out as our mood tends to shift and shake when we’re going through times of change, uncertainty and fear. Aka, 2020-2021. 

Many people have noticed that over recent months their mood has felt “up and down” or (as one patient recently told me) “not just all over the shop, but the whole town”. 

Adjustment reactions are sets of symptoms that occur when our mind is trying to find solid ground with significant change or loss – mood swings are a common part of this, and so they’re something that both men and women have been asking a lot about lately. 

How can I sleep better?

Sleep is incredibly important for our body and mind. It influences how our body functions, our risk of disease and even our overall life span. This year has made sleep particularly tough to come by for a lot of us, as stress, anxiety and depression all make it take a hit. Statistics point to up to 50% of people going through at least one significant period of trouble with their sleep each year, and during times like the pandemic you can bet those rates are even higher. 

Some of the best ways to help get a bit more much-needed shut eye are centered around what happens before bedtime. As best you can, stick to a consistent bedtime and wake time, dim your lights in the hours before bed and stay off screen devices within an hour of bed to begin prepping your body for sleep. It can also help to avoid caffeine six hours before you’re planning on hitting the hay and watch out for too much alcohol (which fractures sleep while we’re doing it). 

When is a problem actually a problem – when should I get help with my mental health?

This is another very common mental health question. There is never a solid yes/no answer, and so the 101 here is that if you’ve stopped to ask yourself the question, then that’s the point to reach out. 

Changes tend to progress over time so it’s important to take time out to reflect on your mental health and identify if anything has changed significantly. Some signs that indicate it might be time for you to ask for help are: 

  1. Noticing significant changes have occurred to the way you’d usually feel, think or act on a day-to-day basis
  2. Feeling significant distress from what we’re going through on a daily basis and/or when we can no longer do or enjoy the things we normally would or need to
  3. The presence of any thoughts about self-harm, suicide or harm to others (which is a signal for urgent need of support)
  4. Notable changes to sleep, diet, energy levels, concentration or physical health that can actually be signs of mental struggle themselves 

There’s never any shame in reaching out for help, and the good thing about 2020 is that we’re all more plugged into the mental side of things and in it together. Start by opening up to loved ones (even a single person you trust), and a good place to start regarding professional help is to check in with your GP to see what further steps might be needed.

Is it normal to express stress and sadness as anger?

Absolutely! Our minds are complex beasts and how one person responds to an event or emotion is going to be different to how another might. 

When we’re going through change and significant stress, it’s not unusual for your mind to move into fight or flight mode as a means to protect us and keep us safe. While this is a helpful response in some ways, most of the time it can make us feel stressed, anxious and even tired. Anger and irritability can be a common throwback here as well, but for many of us anger is actually a means of expressing fear and sadness. 

Acknowledging this (and the deeper feeling under anger) is the best place to start, as is exploring means to diffuse distress and fear through more helpful means like exercise or talking it out. This can be tricky, so talking to a professional if you’ve noticed anger and irritability ramping up is key.

What are the biggest impacts of the pandemic on mental health?

Most areas of our life have been affected by the pandemic (to say the least) and this has definitely impacted our mental health. From losing your job, being isolated from family and friends or being concerned about contracting the virus itself, it’s understandable that many have felt alone, anxious and low these past few months. 

A sense of isolation has been one of the biggies for pandemic life, and for those who live alone it’s been difficult to find that same sense of connection. Statistics show us that these impacts have been felt the most by young people, and for those who’ve found themselves out of work or with major financial strains. 

The key here is that you’re not alone and these big impacts are ones that many have been feeling. If you feel like it’s time to get help with your mental health, a GP is a great place to start the conversation. They may refer you to a psychologist who can help you with subsidised sessions through the Mental Health Care Plan.

Why is change and uncertainty so damaging to mental health?

What many people might not realise is that the mind is built to predict, manage and problem solve day in day out. It’s this very reason why change and the unknown can feel so confronting. 

One of the key reasons this year has been so difficult in terms of our mental health is the sudden shift in our routines, and habits and go-to’s to keep us feeling ‘us’ that have truly knocked our brains for six. It’s normal to place a lot of our self-worth and identity on our job, our position at work and how productive we are – all of which have been massively impacted by this year. 

This has, in many ways, forced us to look past these areas to find a sense of self, purpose and meaning. While our mind is incredibly resilient, it can take some time to adjust to these changes but know that you will come through and adjust.

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