Managing Mental Health: Strategies for Stress and Success
March 19, 2024 | Episode 12
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Marcus Thorpe, Dr. Megan Schabbing, Missy Gleason
Marcus Thorpe 00:14
Welcome back to the wellness conversation an OhioHealth Podcast where we explore health and wellness right here in the state of Ohio. I'm Marcus Thorpe.
Missy Gleason 00:21
And I'm Missy Gleason. Today we're talking about mental health, a topic that touches us all in different ways. Whether it's personal challenges or supporting our loved ones. Understanding mental health is crucial.
Marcus Thorpe 00:33
And we have someone who is perfect to lead our discussion on this very important topic. It's Dr. Megan Schabbing the OhioHealth, medical director of psychiatric emergency services. Dr. Schabbing, welcome to the wellness conversation. It's good to have you.
Dr. Megan Schabbing 00:44
Thank you, Marcus, and Missy. Thanks for having me.
Missy Gleason 00:46
Absolutely, so we know this is going to be an informative conversation. And we want you to remember, there's no one size fits all when it comes to mental health. Everyone is different. We hope you use this discussion as a starting point, and then take the steps to find the best fit for you. Okay, so to start us off today, Dr. Schabbing, can you share a little bit about your professional journey, what led you into the world of psychiatry and mental health?
Dr. Megan Schabbing 01:10
Sure, I really started thinking about going to medical school in high school. And it's interesting because when I look back now, I think I should have known even when I was a younger kid, that I was going to become a psychiatrist. Because even back to the days of probably like late elementary school, junior high, and definitely high school, people were always just talking to me about the problems, I mean, all kinds of different people. And so So now when I think back, it really makes sense. But when I first started, kind of really seriously, considering medical school, I started volunteering in the hospital, I always gravitated towards the emergency department. And then as the years went by, and I went through, you know, the classroom, part of medical school, and then my clinical rotations, I still really loved emergency medicine. I love that fast pace, scene and sort of just that whole atmosphere in the emergency department. But of course, I found that I love psychiatry. And so as my whole career has developed, you know, I started off doing inpatient psychiatry on the inpatient psychiatric unit, started the transcranial magnetic stimulation program here, did some outpatient consultation, did work on the medical and surgical floors, doing consults, I met at a number of our sites. And when I finally ended up in the emergency department where I am now and created this whole system that we have, where we cover all of the emergency departments throughout OhioHealth, and all the patients that come in with mental health crises, it really is the perfect fit for me, because I'm now a psychiatrist in the emergency department. And I love that job.
Marcus Thorpe 02:42
So let's talk about the current state of mental health kind of big picture view. What are you and the team from OhioHealth really seeing? Are you seeing the need for mental health resources grow? Where are we when it comes to mental health and the care that we give?
Dr. Megan Schabbing 02:55
You know, I have found that as years have gone by, throughout, you know, the past 12 plus years that I've been practicing mental health has become more and more of a conversation, which I think is awesome. And, yes, we are very busy in the emergency departments and throughout the system. You know, there's such a demand for psychiatrists and therapists and mental health professionals across the boards, whether it be out in the community, and the emergency departments on our medical floors. You know, addiction is a huge issue. We know that we're right at the epicenter of the opioid epidemic here in central Ohio. And now Methamphetamine is a huge problem. And so, you know, I'm grateful for the fact that people are wanting to talk about mental health. And I think that's part of it, I think that more people are coming forward. And talking about mental health problems, you know, both celebrities and non celebrities, telling their stories, talking about going to a therapist having anxiety being diagnosed with bipolar disorder. And I think subsequently, there are more people out there in the community that are finally coming forward and saying, hey, I might have some of these same problems. Whereas before, you know that stigma was greater than ever, and I think slowly, but surely we're chipping away at the stigma. So definitely, our volumes are very high. Our Behavioral Health Program here at OhioHealth, just continues to expand everybody everywhere is asking for more in terms of mental health resources. So I'm really grateful to work in a system where we prioritize people with mental health problems. We're not afraid to talk about it. You and I are out here talking about it all the time. Right? And I think OhioHealth as a system has really decided to invest in this whole space, and I'm really proud to be somewhere where we're doing that. But even through COVID Our volumes stayed pretty high in the emergency department, specifically with mental health patients even when nobody else was coming to the emergency department. We still stayed really busy with people coming in struggling with anxiety, depression, feeling suicidal etc. So, post COVID, it's a whole different world, different problems, still very high volumes. So yeah, this, is the time I think, for people to, you know, kind of come forward if they're struggling and reach out for help, because we're trying to really increase what we can offer to the community and to every single person out there that might be struggling with a mental health issue.
Missy Gleason 05:22
So I'd love to know like, Are there signs or symptoms that people should be looking for that kind of is a red flag for themselves, that they might be dealing with a mental health issue, as opposed to just having a bad day or feeling a little down?
Dr. Megan Schabbing 05:35
Definitely. And you know, of course, we all have days, where we have a bad day, or we're feeling the blues or feeling a little bit down. But where you really want to think about coming forward and reaching out for help is when whatever the problem is, if it's feeling depressed, feeling sad, feeling angry, worrying, if that problem is making it hard for you to function on a daily basis, whether that be at school, maybe your grades are slipping, you're having trouble concentrating at work, and your performance is slipping at work. Maybe you're showing up late for work, or you're missing work or school, or it's just interfering with your ability to enjoy your family, it's interfering with relationships, that is a red flag. And I always say to people, you might think that that's a problem that every single person has to deal with. I have people that tell me that all the time, when I asked them if they're suicidal, they say but yeah, isn't everybody? Doesn't everybody feel like they want to die? Sometimes? And I tell him, no, not everybody feels like that. Not even sometimes, you know, and you don't have to feel like that. So if it's something that's really making it hard for you to function on a daily basis, in any of those areas of your life, it's time to reach out and get some help, because these are fixable problems.
Marcus Thorpe 06:49
Are you seeing more and more people come forward that have never had those kinds of issues? Or they've never dealt with any of this before? Maybe even pre pandemic, you're seeing first timers who are saying, I'm having mental health things that I've never had to deal with before? Yes,
Dr. Megan Schabbing 07:06
We really are. And like I said, I think some of it is maybe that people are starting to feel that maybe it's more acceptable to have a mental health issue just because it's more talked about than it used to be. And it's less of sort of a secret. And so many people are talking about their mental health issues that I think that's having a trickle down effect, which is great. But also, one thing we know is that for instance, when it comes to suicide, over half of people who die by suicide now have no prior known mental health problem. And so if you think about that, why is that? How is that happening? One thing we know is that even if someone doesn't have a known mental health issue, like anxiety, or depression or something like that, if someone is going through what we call a stressful life event, that could be a divorce, that could be losing a job losing a home, having a relationship problem, whatever it may be, that person can really be at a higher risk, a significantly higher risk for suicide, for instance. So I think there are these various factors that are contributing to people coming forward who have never struggled before with mental health issues, and really getting that help and finding that they don't have to live with that struggle every single day.
Missy Gleason 08:18
For somebody who is just starting to experience this and has no history of going to therapy, what are some first steps you would suggest for them?
Dr. Megan Schabbing 08:26
The best first step is to talk to your primary care physician if you have on your primary care provider. The reason is, a lot of times mental health issues like anxiety, or depression or other types of problems that look like mental health issues, there may be an underlying non psychiatric medical issue going on like something with your thyroid or another type of medical problem that we want to make sure we rule out first, before we go full speed ahead and treat it like purely a mental health issue. So that's a great first step, if you don't have a primary care provider, this is a really good time to get one. I even tell my doc friends, you know, physicians are sometimes famous for not having a regular doctor, and I even remind them, go get a primary care doc. And if something's wrong, go talk to that person as a first step.
Marcus Thorpe 09:12
We'll talk about treatment. Again, we're talking about mental health, big picture. There's no one size fits all for everybody. So what might work for someone may not work for somebody else, but just talk about therapy, and medications, maybe other options that folks can start asking questions about that might get them in the right path.
Dr. Megan Schabbing 09:30
So first and foremost, you know what the best treatment would be for any kind of mental health issue is completely dependent upon what that mental health issue is. And so that's why it's so important to get the right diagnosis. I always tell people, it's kind of dangerous to just get online and start Googling things because you don't even know that the problem you think you have is the problem that you actually have. And as we always talk about in the hospital, we've got to make the right diagnosis, particularly in the mental health space where it's harder to make diagnoses there. is not an easy test for, you know, major depression or for generalized anxiety disorder for even bipolar disorder. So it's really important that you see a professional who can make that appropriate diagnosis. Once we make that diagnosis, I'll give an example if you have an anxiety disorder, whether it be kind of what you think of as anxiety, like excessive worrying, that's interfering with your daily life, or another kind of anxiety disorder, like post traumatic stress disorder, or panic disorder. For many anxiety disorders, there are very specific types of therapy that are extremely effective. And you may be able to get that specific type of therapy with a trained therapist for the right amount of time, the right frequency of visits, and it may be as effective as a medication. Now, for severe anxiety disorders, usually, it will require both therapy and a medication. For other disorders, like bipolar disorder, for instance, which some people think of as manic depression, or schizophrenia, it's really going to most likely require medication, I mean, the most evidence based treatment and even for major depression, the best treatment is medication antidepressant treatment. So it is very important, though upfront to get the right diagnosis, I can't emphasize that enough. And so it's perfectly reasonable. And I do encourage people to educate yourselves, you know, go to a good resource and you can read about some of these problems and and start to get a feel for, Hey, maybe I can I can relate to that you read about an anxiety disorder, and you read about the different symptoms, you think that may be something that I have. But before you go and try to seek out various treatments, it's important to see a health care professional and get the right diagnosis before you go full speed ahead with any one treatment.
Missy Gleason 11:42
I really appreciate the fact that you talked about just going to your primary care doctor is the first step because honestly, I would, I would not know what to tell somebody else. So that was super helpful. But when should somebody think about heading to the emergency department? What are the signs?
Dr. Megan Schabbing 11:57
So a visit to the emergency department is definitely indicated, if there's any concern that somebody is having suicidal thoughts with any kind of an intent or plan to act on them, or if somebody already has acted on those thoughts, to hurt themselves, or to try to kill themselves in some way. If we have somebody that's having thoughts to hurt somebody else, and we think it may be related to a mental health issue, you know, that's definitely a visit to the emergency department. Also, we have people that come to the emergency department, and, are right in doing so because they have a mental health issue, whether it be anxiety, or mood symptoms, or whatnot, that that symptom is really keeping them from getting up and getting out of bed. So we have people who just are not functioning, maybe they're not eating or they lost weight, or they have medical issues that they're not caring for, they're not taking their blood pressure medicine, or other medicines that really put them at risk. That also would be a trip to the emergency department. So certainly, we want people to reach out early on when they're having, you know, some of the kind of early signs. But if it's at that crisis moment, that needs to be a trip to the emergency department, or a mental health crisis center if you have one in your community.
Marcus Thorpe 13:12
And we were talking mental health with Dr. Megan Schabbing, who's the OhioHealth, medical director of psychiatric emergency services, let's shift gears and talk about our kids. Certainly a big part of the mental health journey, lots of challenges and things that are coming their way. Talk about how mental health looks for kids, and maybe how it is a little bit different than how an adult would deal with their mental health crisis or something that's going on in their world.
Dr. Megan Schabbing 13:34
So it's interesting, because with kids, especially younger kids, some of these mental health problems like anxiety or depression can present a little bit differently than they do in adults. Now, of course, there are times when a child may say, you know, express, feeling sad or feeling down. And that might be a little bit of a warning sign for depression, or that you know, you can tell that the child is really worrying a lot about something or about many things that may suggest that the child is experiencing anxiety. But there are other ways that these mental health issues can can kind of come out with kids. So I'll give you an example. For many children, if they're experiencing anxiety, they may not say that they're anxious, they don't even know what that means many of them, right? They may not say I'm worrying about all these things. They may instead be having stomach aches very frequently, or headaches or other physical problems. Going to the nursing office over and over again at school, when really ultimately no medical issue is determined to be at play. That is a big red flag for anxiety and kids or other types of mental health problems. If you have a kid that's having headaches a lot, that can be anxiety, and an in terms of depression, it can look a little differently in children as well. So sometimes in a child who's depressed instead of crying a lot, or saying I'm feeling sad, that child may experience really inappropriate guilt. So for instance, let's say that child spills a glass of milk And then it's just crying hysterically and you know, feels like the worst person on the planet, you know, that could be a warning sign for something like depression in a child.
Missy Gleason 15:10
It's very helpful. kids and teens are also exposed to a lot. So not just what's going on inside, but what they're seeing on the outside, online, on the bus, in the classroom. What can parents do to support their kids mental health and helping them through those challenges?
Dr. Megan Schabbing 15:24
It's really important that we, as parents kind of kick it up a notch these days, because it's nothing like what it was for us, right? I mean, they are exposed to so much that they can read on the internet that they can see images of on the news and on YouTube, and all of these things that we didn't have, right, that we weren't exposed to these types of stressors, potentially as kids. So number one, as a parent, the first thing you can do is just open the lines of communication. And I always say a nice easy thing to do as a parent, is to just check in with your kid at some point every single day, if you want, it could be the same time every day. So if you have a kid that you pick up from daycare, or you pick them up from school, and you have a little drive home, that might be a good time to check in with your kid, if you're a family that maybe tries to have a family dinner, that would be a good time to check in. But sometimes, especially with teenagers, you gotta get a little creative, right, because not every teen wants to be drilled about their day, particularly when they get home or even at the dinner table. I'm speaking from experience. So one thing that can be helpful, particularly with teenagers is just do a shared activity with your teen, whatever your teen wants to do, you kind of gotta go on their terms, right. So if your kid likes to shoot hoops go out there and rebound for them, even if you're maybe not shooting with them, and just hanging out with them. And sometimes you'll find that they'll just start talking about things and that's a little bit less pressure for a teenager than us sort of drilling them and especially if you think something's wrong, trying to check in, just find some quality time with your child every single day. And, and have that opportunity to touch base and hear how they're doing and and give them the chance to talk about things that may be on their mind,
Missy Gleason 17:09
I've always found that the car has been super helpful for me, I don't know if it's because we're facing forward, and they're not looking like I'm not making eye contact with them. So it's easier for them to talk. But I found that super helpful. And I have a child away at college. So now I'm just much more blatant about it. Like I literally will text him and say, mental health check, how's your week going? And like and, reinforcing that we're a team. And he's not just because he's away from his family. He's not alone. So what can we do to help him and support him. And I found that being very straightforward as they get older. And letting them know it's okay to talk about these things is very, very important.
Dr. Megan Schabbing 17:46
Well you bring up a really good point, because sometimes, especially with teenagers, if you look them in the eye at the dinner table, that's a lot of pressure. But you're absolutely right. Take advantage of the fact that the teens are on their phones now, for better for worse, right. And we can talk about that. That's a whole other issue right? Screentime. But I think one good thing that you can do with your teenagers is check in with them through text, just checking in, how's the day going? You know, I mean, it's, again, sort of a less pressure scenario for a teen. And then I think, you know, the reality is whether we like it or not, we have to be aware of what our kids are doing on the internet, on their phones. And so, you know, there's some really great recommendations that the American Academy of Pediatrics has for parents, for kids of all ages, in terms of screen time, in general, for younger kids, you want to try to limit that total screen time to about an hour a day for adolescents closer to two hours, probably. And then you want to know what they're doing. And for instance, maybe have them keep their phones downstairs at night. That's a really good recommendation. You know, I think it's a lot of pressure as a kid, especially as a teenager, to be on the go with your phone all the time. Imagine how exhausting that would be and how stressful that would be. So I think that sometimes if you just take that option out, away from them, and just say, You know what, your phone, you go to bed at 10, 10:30, your phone stays downstairs, you'd be surprised at how much of a relief they may actually find that to be because you're not even giving them that option. So the screen time is important. We know that too much screen time is really detrimental to our kids and teens. And so you got to stay on top of that. And you got to kind of put down those boundaries as a parent.
Marcus Thorpe 17:47
I know that we live in a very polarizing time. Another election cycles coming up, disagreements amongst family members or friends. There's disturbing news almost rapid fire sometimes when you click around and look at that, out of those types of things, from an environmental standpoint, impact our mental health.
Dr. Megan Schabbing 19:45
Well, because we have such immediate access to all of this news, much of which is bad news, right? And sometimes just horrifying news or images or whatever it may be on the internet. It's really important that each one of us be very thoughtful and deliberate about what we're doing with our screen time, and what we're doing in terms of getting on the internet, getting on social media. And so I would say when it comes to, you know, polarizing issues, like the election and other issues throughout the world that are going on right now, resist the urge to go down that rabbit hole. And you know what I'm talking about, you know, everybody's done it probably at one time or another, where a story comes out, and you start reading about it. And then you're looking at every different website, and getting every different angle on the story. And at the end of the day, you feel terrible, because it's a terrible story, or it's something that makes you feel terrible. So I always tell my patients, you know, it's important to be deliberate about what you're doing in terms of the internet, and social media, you know, pick maybe one or two news sources that you're comfortable with that somehow speak to you that you know, that it's sort of within your comfort zone, stick to those. Limit the time. Think about people that you can follow on social media that actually make you feel good, that bring positive ideas into your life, maybe shared activities, you know, switch it into something that can be a positive for you, and definitely put limits on it.
Marcus Thorpe 21:11
Doom scrolling stay away, no good.
Missy Gleason 21:16
So we talked a little bit about self care, and how it is a really important part of day to day life, how does that play into long term success of our mental health?
Dr. Megan Schabbing 21:25
So as I said, I think preventative mental health, as I like to call it is something that we really need to be thinking more and more about. And I love to hear people talking about self care. That's a term we didn't even really use to use when I was growing up at least. And I really appreciate the fact that a lot of people in this younger generation seem, you know, to be more in tune with self care. So what I tell people again, sort of like what we say we should be doing with our kids. Similarly, you should check in with yourself every day. And I view that as preventative mental health that's really going to pay off in the long run, if you earlier rather than later in your life can figure out what works for you, in terms of what's your happy place. What works when you're feeling stressed, that can help you kind of cope with that stress, manage that anxiety, you know, and feel better. The sooner you figure that out, the better. And then again, you have to be deliberate about it, you have to kind of take, even if it's just 15, 20 minutes a day, you have to take that time to yourself. For some people, it might be meditation, for some people, it may be, you know, exercise, taking a walk, even picking up the phone and calling somebody that you love that you don't get to see very often, or somebody that whenever you talk to them, they make you feel good, you feel like you can vent to them about your problems, whatever it may be, take that time every single day, prioritize that time, and it will pay off for you in the long run. Because if you're doing that, even when you're not having a terrible, terrible time, then when a really rough time comes up in your life, you've kind of already got those tools in your tool belt. And it's going to be easier for you to just use those tools.
Marcus Thorpe 22:57
Yeah and watch for your family and friends, you know, be in tune with what's going on with them. Because they may be struggling and you might be the one that sees it and can do something or suggest something or help them right?
Dr. Megan Schabbing 23:07
Absolutely. I cannot tell you how many times somebody comes in in the emergency department, whether it be a child, a teen, or somebody that's an adult, where the only reason they're coming to our attention for being suicidal or having severe anxiety that's limiting their ability to sleep or to function, or being so depressed that they're not getting out of bed, they're coming in only because their friend or family member brought it to our attention. Or many oftentimes teens end up in the emergency department because a friend reported to an adult, hey, my buddy just texted me that he's feeling suicidal. And it's so important to check on one another check in with one another, and then help each other get the help that we may need. When you see these red flags, start the conversation, check in with that person. And if it is one of those red flags scenarios where it's a trip to the emergency department, or it's something that really is interfering with their ability to function, mental health wise, then help them reach out to get the help that they need.
Marcus Thorpe 24:04
And there is hope. And there's help available. And we encourage everybody to start that process. If you're feeling like this, know that there is light at the end of the tunnel. And I think that's really important for people to realize. So thanks Dr. Schabbing, before we wrap things up, we do want folks to get to know you a little bit beyond just what we're talking about. This has obviously been really serious topics, but also really important. So you want to do some quickfire round to get to know you a little bit better?
Dr. Megan Schabbing 24:30
All right, I'm on it.
Missy Gleason 24:32
Awesome. Okay, so, Dr. Schabbing, you're recently married and to another physician. So how much work? Do you talk at home? Or do you try and avoid it completely?
Dr. Megan Schabbing 24:40
That's a good question. We actually do talk a little bit of work at home but it's limited. We run things by each other. You know, we're in different specialties for sure. So we might curbisde each other if we have a question or just get advice from one another. Or quite frankly, we might vent if we've had a rough day we vent. But I can tell you that the majority of our time at home is all about our kids and So we sort of talked about those things when it's just us usually. And then the majority of the focus is is on the kids, it's on the family. But it's nice to have each other to kind of, you know, like I said, run things by that to one another that that can be helpful.
Marcus Thorpe 25:15
If you didn't choose this as a profession, is there something else you think you would be doing? If it wasn't the physician route?
Dr. Megan Schabbing 25:20
Yeah I think it'd be a detective, or maybe a lawyer, but I probably detective would be the top one, you can ask our protective services team, I think they would agree.
Marcus Thorpe 25:29
Detective, I like that.
Missy Gleason 25:31
So you deal with a lot of heavy things in your day to day, how do you unwind?
Dr. Megan Schabbing 25:35
So I try to practice what I preach. So I'm very deliberate about my coping strategies. And I start every single day, with a cup of coffee and a run, I go running in the morning. And I always say, that's kind of how I clear my head, so that I can then absorb everybody else's problems, and then my brain when I get to work, and then similarly, when I leave work, I'm pretty deliberate about trying to some extent check out I'm always available for work if they need me in a healthy way and appropriate way. But I sort of will switch into soccer mom mode, my son plays soccer, and that's my happy place on the soccer field, go OOP. So it's all about soccer. And we have a puppy. So I'm exercising the puppy. We have a lot going on, I'll call a friend on the way home, you know, I have a really good dog friend that I'll call and sort of, we may talk about work stuff. But more often times we'll talk about our kids, we'll talk about other things. And I'm able to sort of unwind from work in that way. But it is definitely a deliberate choice before and after work to try to kind of use those coping strategies and and check out a little bit.
Marcus Thorpe 26:37
And finally what's the favorite part of your job? What do you love about what you do?
Dr. Megan Schabbing 26:42
I love so many things about my job. But I have to say, the best part about my job, I sort of call it the Grey's Anatomy moment where I always say my team and I talked about this, there's always at least one moment in the day where I connect with a patient in a way that I always think if I had a GoPro on my head, or this was a reality show, and people were watching from home, they would be tearing up. And of course, as a psychiatrist, I have to maintain my boundaries, and I don't start tearing up myself. But that moment where I really feel like I'm able to get through to somebody and meet him at their worst and most vulnerable moment and just find some way to get things moving in the right direction to bring them hope or to try to help develop a plan to get them feeling better. So that that's probably what I love the most.
Marcus Thorpe 27:23
Love that. Well, we really appreciate the time and the information. We both know you from the professional world because we both did Media Relations and worked directly with you. I do currently and so we knew you'd be a great guest and you certainly lived up to that. So thanks for joining us.
Dr. Megan Schabbing 27:37
Thank you for having me.
Missy Gleason 27:38
Absolutely, so thank you for joining us for this episode of the wellness conversation and OhioHealth podcast and before we wrap up, we invite you to check out the OhioHealth hub. It's a one stop shop to connect you with OhioHealth social channels newsroom wellness blog, newsletter, and of course, our podcast page. You can find it at ohiohealth.com/the hub.
Marcus Thorpe 27:59
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