Dr. Phil Gives Mental Health Tips for the Holidays

[MUSIC PLAYING] Welcome, everyone. I'm Dr. John Whyte, the Chief Medical Officer at WebMD. We're almost two years in the pandemic, and people are still struggling. So what do you do? How do you continue on? Well, joining me today to answer those questions is one of our most popular guests, Dr. Phil McGraw. Dr. Phil, thanks for joining me.

Glad to be here, and so glad to be talking about this because it still is a big challenge.

You have graciously agreed to open up your home. We're here during the holidays, people are celebrating. but you and I have had many conversations over the past 20 months, and I have to start off with asking you, are you surprised that we're still talking about this?

I'm really not. Sadly, I'm not. In one of our first conversations, we talked about the fact that I felt very strongly that the mental, emotional impact of, not just the pandemic, but the quarantine from the pandemic, was going to outlast the actual Coronavirus itself, which, of course, is still going on. But I think we're going to be seeing the fallout, the mental, emotional, and developmental fallout for children, probably, for decades to come. So I'm not at all surprised that almost two years in, that we're still dealing with the problems.

And you said to me early on, you said, John, we've got a mental health pandemic as well as an infectious disease pandemic. And just for reference, for our audience, a recent study showed that 4 out of every 10 Americans, 4 out of 10 are suffering anxiety or depression. And for reference, pre-pandemic, it was 1 out of 10.

Substance abuse is way up, including drug overdoses, up 30%. 100,000 overdose deaths. People are suffering from PTSD from the pandemic. So I have to ask you, what's driving these mental health challenges? Is it uncertainty? Is it this idea-- is, Dr. Phil, one day we're doing pretty good, and then the next, it's back into-- are we going to get locked down? Is it false hope? What's driving all of this?

Well, I don't think it's one dimensional, as you just mentioned. First off, there is just fear. Not uncertainty, but the certain fear-- we're now approaching, what, 800,000 deaths? So this is a real problem, and almost everybody knows, by some degree of separation, someone that has been seriously impacted by this, either death or serious illness.

So this is a very real thing. So people have a genuine concern for themselves and their loved ones. So there is this looming fear, and that creates a lot of anxiety for people. And then, the uncertainty, because, I mean, we start getting variants. And they think, OK, we're going to do vaccines, and there's some fear about, is that OK to do. And then, we start to see a decline, then here comes another variant. And then a decline. Here comes another variant.

It's sort of like people are, like, enough's enough, and too much is too much, and we're into the too much now. And so, people's coping energies, their sustainability is really being stretched. And so, it starts showing up at pathological levels of anxiety, depression, loneliness. And I fear we're going to start seeing some learned helplessness out of this, which we can talk about in a minute if you would like.

And then, you add to it the economic burdens of this, because so many people have lost their jobs, lost their businesses lost their livelihood, and they don't know how they're going to provide for their families. And so, that burden, that uncertainty-- and frankly, Doctor, so many people measure their self-worth a lot with their careers, their ability to provide for themselves and their families. And when that's taken away, a lot of their self-worth is damaged. And so that takes a beating.

And all of these things aggregate really create the PTSD, the depression, where they feel like, my gosh, what can I-- I don't have the ability to fix this. It's not like I can move, go to a new town, start over, because the Coronavirus is there. The problems are there too. And that's what I mean when I say learned helplessness.

Yeah, I was curious as to this concept of learned helplessness.

Learned helplessness is-- it's a perceptual set where you learn that nothing you do can change what's happening. And it's like whether you do A, B, C, or D, it doesn't matter. You learn that you don't have the ability to impact the outcome. And as a result, you learn that you're helpless to change the course of events, and at that point, you stop learning.

You're unable-- somebody can bring something that is, in fact, a solution, but you've closed the window, the perceptual window, so you don't learn it. And at that point, people stop looking for solutions, they stop looking for outcomes, and surrender to the idea of being unable to help themselves.

And that occurs when this hasn't worked, that hasn't worked, this hasn't worked, and they finally say, I give up. And so their data window closes, and they just don't-- they stop looking for solutions, and they stop recognizing solutions. And I fear that we're going to see that start creeping in, if it hasn't already. And that's--

Well, how do we prevent that?

--why we see so much depression.

I mean, you've been very good over these past 18 months for providing tips, providing tools, talking about what people need to do, talking about the concept of resilience. So how do people get to that point, of being resilient, in some ways?

Well, I think two things are really, critically important. And there's more than two things, but two really jump out at me. And number one is recognizing that we're not alone in this. It's so important to give your feelings a voice. Talk about these things, because if you really isolate and keep all this inside-- monsters live in the dark, and if you turn the light on, then everything seems more manageable.

And when you talk about it, you realize other people share your problems, your issues, your concerns, and you do feel a sense of fellowship, a sense of camaraderie. And together, we're stronger, and I'll support you, and you support me, and maybe we come together.

And if-- maybe you're out of work this week, but I'm not. I can help your family, and next week you can help mine. We don't feel alone. We do feel a sense of community if we're all in this together. So I think it's important that we talk about that, whether it's at church or support group or in your neighborhood or in your family. Give it a voice so you don't feel alone.

And then secondly, recognize that small changes add up across time. We don't have to leap tall buildings in a single bound. If we can just set small, realistic goals-- and maybe this week, it's that we start working on our resume. And maybe, then, we start getting our wardrobe ready, our work clothes ready again.

Then, we start putting together a list of all the places we're going to contact for employment. We start looking for ways that we can trim our budget back. We start finding things that we can delegate so our children can help out more around the house, to give us more time to get back into the-- just small changes that maybe we took for granted before, but if everybody pitches in, it's like-- the first six months of the year are going to go by whether we're doing something about our circumstance or not.

Little changes, week after week. Then pretty soon, we realize, wow, we're in a really different position than we were three months ago. And it isn't like we made a big leap to get there. We just made a little change each day, each week, and then we got back on our feet, and we were out there. Little changes add up.

So we're here, as I mentioned, in your home. The holidays are approaching. Holidays can be stressful without the issue of the pandemic. And you and I talked several months ago. One of our talks was about, how do you deal with family members who don't believe COVID is real, who don't want to get vaccinated. We're six months past that, right?

So now, people still are saying, I don't want to do it. It's not safe. We want to gather because we want to address that issue of loneliness. So what's your advice now, Dr. Phil? Do you not mention it? Do you not bring it up? Do you say everyone's got to have a home test before they come over? Because you could be making some relationships more stressful. What's your advice?

Well, I think, first off, we have to assess our risk level. If we're taking grandma with us, and she's advanced age and has some underlying conditions, where there truly is a problem if she does get exposed, then we do have to go to greater lengths than we might if that's not the case.

So we do have to do a risk assessment, and if there are people that could really be impacted, we truly do need to make some statements before we get there and say, look. You may feel one way, and I feel another, but out of respect for someone that really has a high risk level, can we agree that everyone is going to be at least tested before they come in. And | made real advances with really high-speed testing that you can get at your grocery store at pretty nominal fees.

I'm not doing it. I don't want to do it. What do you say? Because that's a real thing.

We do have to make some hard decisions. If it comes down to me being able to spend time with my cousins or putting my mom at risk of her life, I'm going to choose my mom in protecting her life. If I have to make that hard decision, then I'm going to make that hard decision. And a lot of it, I think, boils down to how much you know about who you're going to be around. What are they-- where have they been? What are they doing? How much are they quarantining?

If they work from home with a telemarketing job, and they haven't been out for six months, other than really limited outings and stuff, it's a different situation than somebody who actually works in retail, and they're around people every day. You have to use common sense about this, but there is a line that you have to draw and say, if I have someone that's high risk, I've got to make some hard decisions. And it's not really about philosophy at that point. I think it's just about reality. And you have to protect those that are at high risk.

I want to ask you. When we talked a year ago around this time, are any of your recommendations different, given how long it's gone on, to deal with this issue of resilience? Do we have to change our tools?

I would just encourage people to be even more patient with themselves now, because the deeper we get into this pandemic and the quarantine, the shutdown of the world, the further we are from full functioning. And I have talked to so many people that have said, when I stepped back out there, it was pretty intimidating.

Our office, now, we go in-- they say we go in a day or two a week, and I don't feel real comfortable going in. I feel some anxiety when I go in. So I would encourage people to recognize that that's not a weakness on their part. It's human nature. It's been a long time since they've done that, and they're now doing it with a certain threat. You really do have to do a threat assessment.

And so be patient with yourself. If you don't feel like-- I mean, don't do that and come home and say, well, I'm some kind of weakling that I don't jump back in there and get to full functioning right away. Be patient with yourself. Again, take small steps. So maybe you go in, and you do feel some anxiety, and you have to take a step back. That's OK. Next time, maybe you'll go a little further and a little further. Be patient with yourself.

And that's why it's important to set realistic goals. Do the best you with what you have at the time. And I'm not saying to not require the best that you can do, but do be patient because this-- we've never done this before. The last pandemic we had was over 100 years ago. So none of us were around for that.

Totally different world, literally.

Yeah.

I want to turn to kids. You've been passionate about the need to address mental health in kids. I've had several conversations about it over the past 20 months. The surgeon general recently put out an advisory on mental health in adolescents, saying it's a crisis. And just some numbers for our audience, that 100,000 kids-- more than 100,000 kids-- have lost a parent or a grandparent from COVID, a caregiver.

That the numbers of kids with anxiety and depression have doubled. Suicide attempts are up by almost half. You've talked to parents many times over the past few decades about, how do you bring up concerns with kids. How do you talk to kids. When do you know when to get help. Now more than ever is where parents need guidance. So what do you tell them? Because the parents themselves, we just talked about, may be suffering. And now their kids are. That would not be surprising.

Well it's very likely if the parent-- the most powerful role model in any child's life is the same-sex parent. Second most important is the other sex parent. So if you've got parents that are struggling emotionally, they may very well be sharing that stress, that anxiety, that depression either through modeling, or just because those stressors are present in that home. It might be translating to the children.

So you could have a little bit of the blind leading the blind in this regard. But it starts with the parent knowing what the warning signs are to look for. And you have to look for sleep disturbance, changes in grooming, changes in aggressive behavior, withdrawal from things that the child was doing before, or any types of regressive behavior, where they start functioning as they were at a younger age, whether it's back to bedwetting or less verbal skills than they had, being more clingy or whatever. Any of those things that, in pattern-- it could be a day or two but if we're talking about in pattern.

That's correct, good point.

Then you should take note of it and let that be a warning sign to you that the child might be struggling a bit. And again, I say talk about it and give it a voice. And I always tell parents to talk to their children about things that don't matter. It's kind of like-- people watching this probably watch a lot of medical dramas. And what's the first thing when they go into the ER? They say, start an IV with Ringer's lactate.

[LAUGHTER]

They don't know what that means, but they're just getting a vein open so when they decide what they need, they've got a vein open. That's what I mean when I say talk to children about things that don't matter. You've got the corridor open. You've talked to them about their video games or some TV show or the dog or whatever.

Because if the first time you ever sit down to speak to your child about something important is the first time you've ever really sat down to have a conversation, it's going to be tough. But if you've been talking to them about just anything, and now this time, you're putting something in the channel that matters, it's not so difficult because that channel is open two ways. You've been talking. So hopefully, that channel is open. And you need to talk to them, and say, tell me how you're doing.

Say the channel is not open. Or a lot of adolescents-- just because adolescents, they don't talk much to their parents. What's the next step that parents should do?

They may not talk much, but they're always listening, and they're always watching. And I really recommend that parents not do what you and I are doing right now. Don't put a child down in front of you and say, how are you feeling. Because now, they're going to feel like, oh my gosh, I'm on the hot seat.

You're better off to do it while you're shooting baskets or walking the dog around the block, or anything where the child doesn't feel conspicuous. And it's really helpful sometimes to use a personal example. If you can say, well, I tell you, I've been having a lot of trouble sleeping lately, or I found myself feeling kind of nervous lately. My stomach flutters or something. And I'm not sure what it is. How about you?

Oftentimes, it's a principle of reciprocity. You get what you give. And if you engage the child in a self-disclosing way, then there's a good chance they'll reciprocate the same way. I hear parents sometimes, when they've lost a loved one in the family, and the parent will say, I try not to let them see me cry. And I always-- my first response is always, why is that.

It's OK to let them see you cry, and let them see you recover, because then they know, if I start crying, I can stop. I will be OK because I've seen mom melt down, and then 30 minutes later, she's OK. Modeling emotions and emoting is OK. I think it's good to show that to your child, and they're likely to show it back to you.

So if they're kind of shut down and don't want to talk about it, then sometimes modeling, it helps, and if not, just talking about it-- even if you don't get a response, trust that they're hearing. Even if they're rolling their eyes, like, oh, mom. Oh, mom, come on. They're still hearing you.

We're talking about mental health, but we also saw recently reports that high blood pressure is up 50%, particularly in women. We know that obesity has increased dramatically over the past 20 months. We know now that there is this mind-body connection. There is no physical health without mental health. Has the pandemic taught us that? Because there's still people that don't want to acknowledge that.

Well, they can pretend it's not true, but for every thought we have, there is a physiological correlate. And if you don't think so-- if you're watching right now, just think about biting into a real crisp dill pickle. And hear the crunch, and feel the vinegar exploding into your mouth. And I bet you, a lot of people just hearing me say that start to salivate.

And that's an example. I didn't touch you, I didn't introduce a smell, anything. But because you thought about it, your salivary glands secreted. It's a perfect example of, for every thought, there's a physiological correlate. People that are depressed have a different physiology than those that are not. People that are anxious have a different physiology than those who are not. Those that are relaxed have a different physiology.

And we have seen-- and I know you can bear this out for me. If you really do learn relaxation-- and relaxation is not chilling out. Relaxation is a learned skill of diminishing muscle tension, uncluttering your mind. It can be as simple as making a fist for 10 seconds, and then releasing for 10 seconds. Breathing out for four seconds, and in for four seconds 10 times in a row, where you get into a rhythm.

If you can take 10 minutes and tense every muscle group in your body in a row, and do some breathing, that can really get some tension out of your body. And the effect lasts for hours. Even if you just do it for 10 minutes, it lasts for hours. And so, you can do it a couple of times a day.

Remember, as kids, that used to say, if you get angry, count to 10. That's kind of the adult counting to 10. You take 10 minutes to really get rid of some muscle tension, image something in your mind that's your soft place to fall, something serene. It does accumulate-- this accumulated tension does dissipate, and it lasts for several hours. It can really, really help you.

I want to end with-- you and I talked, almost exactly a year ago at this time-- vaccines were coming on, it was taking some time, and we went over, what's New Year's resolutions. What people should be doing. And you offered these great tips and tools, similar in terms of small steps. We talked about gratitude.

And folks watched it, and many of them are probably watching it right now, this episode, and saying, you know, Dr. Phil, I did all the things you told me to do. I listened very carefully. I've been patient. And now, a year later-- excuse my language-- my life still sucks. So what are you going to tell me now that's going to change something?

Well, a couple of things. You don't know how bad it would have sucked if you hadn't done all those things.

[LAUGHTER]

You don't really think that.

And the other thing is, look. Life is managed. It's not cured. There's nothing I can tell you that's going to cure your life, because if I got your life perfectly in balance right now, where you-- not a problem.

No one is like that.

But let's say we-- hypothetically, let's say we did. Before the end of the day tomorrow, somebody would come along and add a demand, a challenge, a problem, and tip it one way or the other. Life is managed, not cured. And that means that you have to take the tools and use them every single day.

And I think it's important that we set goals, and we refresh those goals all the time. What goals did you set last year? And let's do an audit. Go back and say, what goals did I set in December or January of last year. Which ones did I achieve. Which ones did I not.

But let's do an autopsy, and say, the ones I didn't get, why did I not. And was it because-- maybe you got COVID. Was it because your company shut down. Was it because-- whatever. But focus on what things you're in control of. Not what somebody else did. What do you control that contributed to you not being where you want to be right now.

Because that's where you want to focus. If somebody comes and says, boy, your life is not where it wants to be. Not where you want it to be. Your first hope should be, boy, I hope there's something wrong with me. Because you're the only person you control, and if your life's not where you want it to be, and you say, boy, I hope there's something wrong with me, that's because you control you.

If it's because, well, my company is in trouble, or my wife or my husband's in trouble-- you can't control them. Hope the issue is with you because you can control you. And when you do this autopsy, say, what can I do better. Do I need to be more motivated. Do I need to be in better physical shape. Do I need to set more realistic goals--

And you like writing things down. I remember you talking about that before. You like the idea of actually-- and people don't have to write it down. They can put it in their phone. But there's a benefit--

It gives you an objectivity from it. And you know how, if you open your garage door, and it just, whoosh, collapses on you because it's all--

You've been to my garage.

--so cluttered. Yeah. Think of your mind the same way. I think it's really important to unclutter your mind. And that's why I like making lists and writing things down. Number one, it gives you some objectivity from it. You can look at it and say, OK. I need to do this and this and this. And thinking about it is one thing, but when you go into production mode-- people that have a production aphasia, they can't get it out, are really crippled, and we're not. So let's do it.

And that puts it into another mode, and you get some distance from it where you can judge it, which is very important. But it also uncluttered your mind. That's why I tell people that are having trouble sleeping, and they wake up with their mind racing, keep a pen and pad next to your bed. When you wake up, write down what's waking you up. Write it down, say, OK. I don't need to think about that. I wrote it down. It'll be there in the morning. That can really help.

But unclutter your mind. And get down-- you don't want-- if you have 200 goals, you don't have goals. You need to pare this down to four or five things that you're working on at a time. You don't have to solve the world. Prioritize. Pick four or five things that you want to work on, maybe from different areas of your life. Maybe something with your children, maybe something with your health, maybe something with your career.

That's enough. Work on that, and when you make some progress on that, now maybe you want to add something with your relationship with family members, and then maybe you want to add something with your spiritual walk. But do things in bite sizes, with realistic goals. And you don't really have a goal unless it's observable and measurable.

If you're just saying, I want to be happier. Well, my dog wants to be happy, but how do you measure that? Choose something that is quantifiable so you can tell if you're making progress or not. And then, identify the steps necessary to get there. What are the stepping stones to get across the river? Well, first I need to do this. That'll allow me to do that. Then this.

So you set a realistic goal that's quantifiable, which means it's measurable. Then identify the seven steps necessary to get there. Now, you've got a goal. Now you've got a goal. And if you don't have that, then you're just dreaming. The difference between a dream and a goal is a timeline and an action plan. And that's the big thing you need to have.

And I want to add one thing you didn't really ask-- well, you kind of asked about it, so I'm going to ramble on one more step. Find something, particularly coming out of this pandemic-- and I'm the incurable optimist, that we are coming out of this. If there's not something in your life going into 2022 that you're passionate about, find something.

What's Dr. Phil passionate about?

Oh, I'm passionate about the kinds of things we're talking about right now. I'm passionate about getting people's attention, about managing the quality of their existence, the quality of their children's existence. If you have something that you're really excited about in your life, it makes getting up in the morning so much easier. If your passion is also your job, you've won the lottery.

And if it's your avocation, and not your vocation-- so you're working, so you can get to do that. That's fine. But ask yourself, what am I passionate about. And if you're not passionate about anything, find something and get excited about it. It will change your life.

Dr. Phil, I want to thank you. You've been giving us tips and guidance in terms of mental health during this pandemic for the past 20 months, and I want to express our appreciation to you for providing that guidance. And we're going to keep coming back to you to get more tips. But if you have questions about Coronavirus in Context, about mental health, even a question for Dr. Phil, if it's OK, you can email me at [email protected]. Thanks for watching.

[MUSIC PLAYING]