Nuanced. - 163. Dr. Shahana Alibhai: How to Improve Health Care, Anxiety, Depression & Nutrition

Episode Date: July 2, 2024

Join us as Dr. Shahana Alibhai shares her journey from physician to patient, battling postpartum OCD, anxiety, and depression, and advocating for a compassionate, empathetic approach to mental health in healthcare.Dr. Shahana Alibhai is a family physician and mental health expert, is renowned for her TEDx talk on "Emotional Literacy for Better Mental Health" and her work with organizations like UBC and Scotiabank, blending her personal postpartum anxiety journey with her professional expertise.Send us a textThe "What's Going On?" PodcastThink casual, relatable discussions like you'd overhear in a barbershop....Listen on: Apple Podcasts   SpotifySupport the shownuancedmedia.ca

Welcome back to another episode of The Bigger Than Me podcast. Here is your host, Aaron P. Taking care of yourself mentally, physically, and emotionally is a lot of work. I'm speaking with a doctor who gives insights on this and so much more. She's also the author of Feel Better. My guest today is Shahana Ali Bai. Would you mind first introducing yourself? Absolutely.

I love this question so much because oftentimes it's so easy for me to say, doctor, speaker, mother. But what I am more than anything is a mom of three boys. I've got three young boys, age nine, seven, and four. The two older ones just had birthdays, so I have to remember their ages. And then, you know, for me, it's integrating this world as a physician, as a speaker, and someone who believes so strongly in the role of mental and emotional health. And that seeps into all aspects of my life. Can you tell us about how you got your start and your journey into trying to help people. Such a good question, too, because I think when you go to medical school, I would hope at least

that you have an inkling of I want to serve or help other people. I wasn't like most medical students that they lived, breath, they started their resume at grade four. You know, that's how a lot of them were, that I want to be a doctor. That was not so much for me. I came into it a very long-winded way, and I share that because I think a lot of people out there might not consider a health care profession, but realizing, that you can make it what you want to make it. And that's why I chose family medicine as well.

But it wasn't until I went through my own struggles. I think everything in life ends up being a lot of me search when you are down in the dumps. When you have hit your own rock bottom, that's when I needed to wake up and go, how have I spent 10 to 12 years studying kinesiology, nutrition? I put myself through medical school as a fitness instructor doing all this stuff that I thought was something to do with health and I knew nothing about health. I only knew about disease. And it was after the birth of my first son, nine years ago now that I was diagnosed with postpartum OCD, anxiety, depression, and suicidality, like the whole nine yards. And I sat in front of that reproductive psychiatrist at BC Women's Hospital with my baby and a carrier and my husband beside me. And I just looked at my

husband and went, how are we here? How are we here sitting in front of a psychiatrist? that I refer patients to all the time, but now I'm the patient, and now the psychiatrist is telling me to go on medication and to get help and to seek counseling and on and on. And it was in that moment that I was realizing how courageous my patients are. Because when a patient sits in front of me, I expect them to tell me the truth. I expect them to be vulnerable and I expect them to hopefully listen to my advice or heed my advice. I was the worst. patient. I wanted to pretend that nothing was happening. I thought I was too good for mental health. I thought I was too privileged, too powered, too educated to have anything wrong up here.

But the real truth was that when I was four or five, I started having symptoms and I knew something wasn't wrong. And I hid in shame. I hid in silence. And I did the only thing I knew how. I studied. I studied my way out of insecurity and shame. And so what I really had growing up was a form of OCD called pure OCD, where you only have the thoughts, you don't have the compulsions. And that tends to hit people really hard if you have a pre-existing history in the postpartum time period. So it was basically uncovering everything I had tried to suppress for so long. So when it's you and when you've hit your rock bottom and then you see a patient in front of you. And now you can speak the same language of, oh, I know how that feels

in my chest. I know what depression feels like. I know what it feels like to not want to be here anymore. Suddenly the patient looks at you and goes, wait a second. You're speaking a similar language to me. Right. And I think all of that I needed because I'll be completely honest. Up into that point, it was me here, patient here, right? There was that divide that I tell you what to do. Now it's like this. Now I get it, right? And this is not just become the work that I need when I work with a lot of adolescents. When I look at them, I realize that we need this together. That was very well said.

And there's a lot to take away from that. The first place I think I'll start is you kind of talked about the challenges with the educational system around medicine and health. And I think a lot of people are starting to wake up to the fact that there's an incentive for pharmaceutical companies to want to sell you more prescriptions. There's a business model behind that. So there's not necessarily a goal of you getting off of some of these prescriptions. And that's how they feel in the experience when we see the high opioid use rates. There was an incentive for them to sell more. Could you talk about your thoughts on how we could improve the educational system around medicine and health

and how we work with patients? I think it all comes down to an English lesson that we learn in grade one or grade two. the difference between an adjective and a noun. And I'll get to, you're probably the one of you talking about. And this is something I've thought about for a long time. Because when we're growing up and when our adolescents, especially right now, not so much in our generation, well, I'm older than you, but in my generation, I should say,

we always felt that anxiety was a feeling. It's emotion. It comes and it goes. But in this generation, when you mention the words anxiety or depression, it's a noun. It means a diagnosis and it doesn't have to mean that way. What I'm trying to get at is that we've lost the idea that emotions are like energy in motion. They come and they go. And just because you've mentioned something to a doctor doesn't mean we need to medicate it. That's the saying I always give to my youth. The best example I can give you is a 16 year old who came and told me, well, my youth

worker needs told me I need to go on medication. It's okay. Tell me why. Well, every time I stand up in front of a class, I feel anxious. Is it okay? And she's like, no, that's it. I said, does it affect the rest of your schooling? No. How are you sleeping? How are you eating? Are you socializing? Well, oh, yeah, fine. Just when I stand up to give a little presentation, I feel the butterflies in my stomach. So I need some meds. Therein lies the problem. Contrast that with an example of an 18-year-old who took four hours to go grocery shopping

because every time she walked down the aisle, and if there was anybody in that aisle, she would have to wait for them to leave, quickly go get her grocery, and come back because she had that degree of social anxiety. Look at those two differences. One is an adjective. Anxiety, I feel it. It comes and goes. Don't need to medicate that.

Reassure her that that's actually okay and normal. The second one is the noun. The second one is the diagnosis. So when it comes to, the pharmaceutical companies are always going to, you know, to be there and they're there for a reason. It's the job of the physician or the health care practitioner to help tease those things apart. But the problem, because I've fallen victim and pray to this many times is that when you have a patient in your office and you are given 10 minutes and they have neck pain, shoulder pain, back pain, period pain, and are anxious, sometimes it's easy. I call it the

reflex prescription. It's like fast food medicine. Put in a coin, here's an x-ray requisition. Put a coin, here's a prescription for this. we feel like the more things we give you lab x-ray requisition prescription, the more productive I feel because it takes longer for me to explain that likely all your symptoms are related to anxiety than just to keep handing you those flashcards of do this, do that, do this, do that. So the pharmaceutical companies, I think, are less to blame and it's more the system of medicine and taking that step back and going, why are you here now in my office? And can I hear your story? But in 10 minutes, that's hard to do. How would you go about addressing that problem?

I run late constantly in my patients. That's it. There is like, there's, it's, it's, it's really hard. And that's why I gravitate towards working. I've been a lead physician at the Foundry Abbotsford for the last 10 years and just took over as medical lead there. That's why I love working at a place. like that. Physicians are paid by the hour, not by the patient. You know, they're, thank goodness for the new model that the government has rolled in. All of that is exquisitely important and, you know, no, a lot of appreciation there. But I think when it comes to looking at a patient and the patients in the waiting room, no, they will wait for up to three hours to be seen because they know that sometimes it's as quick as a prescription refill. And other times, everything needs to stop.

And you need to hear that patient for why they are there right now. Interesting. You talked about the challenges you faced and how there was a switch in dynamic in your understanding. How do you start to grapple with the fact that doctors do have such an air of authority over people? And you started to grapple with that within yourself and feel that weight of authority that you had to carry for other people and then start to go, well, I'm just a person and I have my own problems. Did that take a long time? How did you start to break that down? Oh, it's something I called transactional identity. And growing up, I couldn't rely on my athletic abilities. I couldn't rely on my humor. It's not that good. Couldn't rely on my looks. All I could rely on was my academics. So the idea was that if I do really well in school, society has to like me, right? You know, if I tell you that I'm a doctor, then suddenly I will belong to your group. That was the kind of the transactional nature of all of this as well. So when you're talking about that, that dichotomy of authority, that feeling of almost

patriarchy, if you want to call it that, a lot of that comes down to the ego that surrounds all of this. The eagle, I almost imagine, you know, when you bubble wrap something, I feel like sometimes doctors or people in authority are bubble around, bubble raptor shrouded in the sense of, I know it all, I got it all. And I think hopefully the newer trainees are starting to unwrap that bubble wrap and go, actually, we know a little bit more. We've had some experience.

We've had some training. But most of the times the cure is in the compassion. The cure is in sitting down with you and listening to you completely unhinged and unfiltered and trying to go, okay, can I hear pieces of a diagnosis? My job is also to keep you safe and to keep you alive and to hear things like chest pain and whatever that needs to be addressed, but also to take you in at the moment and sometimes the best therapy I can ever give my youth is uttering the words, I am so proud of you. That's it.

That's it. That has done more to them than any prescription for Zoloff or Zipperlex or anything can do for them. So I think that is where you have to start to unpack your own ego, realize that you are more than just a doctor or academics or anything that's led you. to this road of being a doctor and sitting down and, you know, kind of taking all the cards off the table and saying, okay, can I listen to you silently? And that's hard. What is the responsibilities from your perspective of patients? Because there's a movement to go on

WebMD, to go on to these sites, to start to look. And I think there's a role to understand your own body and what ails you and to start to take those steps. You can go extreme and start to think everything's going to kill you. You can go extreme and think that the whole medical system is built against you and that you only have to go natural. And that's the solution to everything is if you just eat natural whole foods. And if you take vitamins and supplements, you'll never need to go to a doctor again. You can go down like some, I think, bad pathways. But there is something about like it's your life. Like a doctor can't cure your life. They can't help you overcome these things. They can assist to a certain extent. A counselor can talk to you to a certain

extent. But it's ultimately you enacting these things every single day. If you want to lose weight, a doctor might be able to prescribe something to help you on that journey, but it's what you eat, it's how you exercise. It's your life to manage. And so you should be the most knowledgeable about your health and your well-being. But it does seem like there's these pathways where people can kind of go in the wrong direction or go too extreme. How do people make sure that they're good patients? What you mentioned so beautifully is this idea that I talk to my patients about that ownership is own your ship. You have to do it. And that exact, that's exactly what you mentioned right now, too. I think I have a lot of patients that are, it reminds me of when my toddler

wants me to pick him up, just like carry me. They become dead weight and they expect the physician or the healthcare system to pick them up. Unfortunately, that's only going to last so long and often doesn't end well. Then you mentioned this whole idea of skepticism around, well, is there a secondary motive or secondary belief behind the diagnosis or the prescriptions. My sister's a naturopath. My husband's a chiropractor. My dad's a pharmacist, right? We see this dichotomy and this actually this important blend. My sister will always a joke that she's like, if somebody is bleeding out, I'm not going to be throwing spinach at them. You know, there is a reason for Western medicine, allopathic medicine. There's a role for alternate medicine. And I don't even like to call it alternative medicine

because I think that what you brought up, the foundation, which is in something that I call the optimal health pyramid, if we go on that quickly, the meat of the pyramid is moving more, eating better, and resting smart. Notice I didn't say exercise. I didn't use the words diet. I use the things that when you think about health, each and every one of us should be putting an effort towards some time in our day. Just move more. Think about what you're eating. And the meat of the pyramid, if you think about a pyramid as a triangle, for example, the meat of it are those three things, because those three things have to do with ownership and they have to do with the decisions you make. When you stand in that Starbucks lineup, like we all do at one point in the day too, you get the decision. Are you going to put the extra whip? Are you going to have the extra sugary shots? Or are you going to say, actually, today, I choose myself, right? Every health is not a destination. It's a serious. of decisions we make every single day. And like Cinderella, the clock resets at midnight, right? So it can be frustrating because it does. But that is what I feel like that ownership is so important, but you also have to learn to trust and have a naturopath, have a doctor, have many people on your team because they all provide a different philosophy, a different input, but they're not going to be the one strapping their running shoes on and going for a walk in the

morning, you're the one doing that. Right. That's a very interesting point. And the piece that I take away from that particularly is around taking these steps and being confident in where you choose to take your health. And when you see people who are going to Starbucks and stuff, it seems like a lot of the philosophy became around like, I deserved it. I've earned it. I've, it's what I deserve today because I just had a tough meeting or something. And it's like we're offsetting it with the sense of like I did something so now I get a reward and the tragedy of that is like but you have a responsibility to take care of yourself for tomorrow and I've heard like clinical psychologist Jordan Peterson talk about this idea you have to take care of yourself today tomorrow next week next month next year

you have to do it in a way that works for you into the future and you can sacrifice a lot of your future for today and have a burger fries milkshake and that will be a reward for today but you're basically trading in your health for the next week because now you've got all of these sugars and carbs in your system and they're addictive and now you're going to do it tomorrow, you have to find a way to balance the heavy workload that maybe you're in school, maybe you have children, you have to find a way to balance all of those responsibilities with taking care of yourself because if you only go in one direction, if you're only about everybody else, then your mental health, your well-being, your diet, your exercise all decrease. And then in two weeks

in a month and a year, you're exhausted, depressed, maybe frustrated that you're carrying all the weight, resentful, and you turn into this person you don't want to be. So you have to think of your life over the long term. You can't just narrow into, today I earned something. It's like, well, how do you want to live over the week? And when do you fit these things in that are gratifying and rewarding? And I think many of us have heard that example of the professor who stood in the top in the front of the room and said, you know, can I fit these big boulders into this glass? And they said, yes, they put the boulders in. What can I fit anything more? And they said no. And they slowly, slowly show that if you put the gravel and then the sand, you can actually fit it all in,

but you have to put the boulders in first versus vice versa, the sand first. So if you think about the optimal health pyramid and those decisions about moving more resting smart, which is something that I don't say just sleep well, take time to be quiet in your day. I'm not talking about lotus pose meditation. Just be quiet when you're driving. And I, struggle and suffer with that a lot because I feel like I always need to be on doing something, listening to something, learning something. And then of course, like we talked about the better decisions about eating, but those short-term gratifications you can pay for a lot in the long term, but it's time that we start reframing things like exercise. It's not to me about moving your body.

It's about resting your mind. If you can think of exercise like that, because what happens when you go for a run or go for a walk or go to the gym or do something that you like, your body's moving, but you might notice that your mind finally, like a glass of water, is finally settled. So what if we concentrated on that as the outcome versus just the movement of the body? Maybe that would encourage more people to go, finally, I know what my mind feels like when it can finally just reach its equilibrium. I'd like to get into all of those specifics, but I'd like to ask, from your perspective,

of working with so many different people, what does an unhealthy person look like? So many ways that I could answer that. But you know what the most unhealthy person is? Is the person that lacks self-awareness? I think a person that is healthier, even if they're not going to the gym and eating poorly and they own it and they recognize it,

they to me, are healthier because they have the self-awareness to know that something needs to change. The person who feels like they are crushing it and they're not and things are really going down a slippery slope, I find those conversations that much harder. We were just at the lake recently and my kids were catching minnows and there was those water bugs, right? Those ones that just kind of sand skim right on the surface of the water. And I was looking at those bugs going, if only people could be like that.

If only people could kind of have that view of them sifting up above the water, looking at what's down below. Like, that to me is the transparency of self-awareness. And somehow our ego, our pride, all of our past traumas sometimes suppress our ability to truly look into that Monica's closet like in friends and go, oh my word, I have a lot of work to do here. Fantastic. You talked about the health pyramid. can we start at the bottom of that pyramid and how do we achieve that aspect? So this pyramid literally came to me on a napkin one day when I was crying beside my five-month-old, who's now nine, and I was in the depths of everything that I had described earlier in this recording right now,

postpartum OCD anxiety, suicidality, depression. So on the back of a napkin, I draw this triangle. It's really a pyramid, but it's a triangle. And on the bottom, the foundation was what I was missing, this whole. time, which is connect deeply. I'd only really connected with my husband. We were best friends in graduate school and then later on in medical school, but I had lost a lot of my other social connections because I had become so vested in this one relationship. And the second piece for that foundation is think better. The book that I'm writing is called Feel Better, but I think think

and feel better relate to the idea that you have to train your brain. Your brain doesn't want what's best for you, it only craves what's familiar. It's only craves what's familiar. It doesn't care whether you're happy or not. It doesn't care whether you're satisfied or not. All it wants is what you did yesterday. That's why when you go home and you put on Netflix and you open up that bag of chips, it feels like you're kind of wearing that nice warm comforter when you're sinking into your covers because it's cozy and warm and familiar. The meat of the pyramid, the middle part is what every single podcast book magazine is about when it comes to health, which is the resting smart, the moving more, the eating well. And the top part is where I put the contribution,

the impact, the purpose. Why are you doing all of this in the first place? Suddenly I was doing a podcast a couple of days ago when it came to me during the podcast that what if this was the equation for life? You know how you have a numerator and then a line and a denominator? What if the numerator was the act of service, like doing whatever you love, you're passionate, you're skilled at in the service of others. And what if the denominator was the knowledge that you are enough? Like that is the ying and yang of life, right? I went to medical school because I didn't feel like I was enough. I'll put it out there. That's the absolute truth. I wanted to be able to name drop at a party that I was a doctor. Now like me, transactional identity. That doesn't, didn't work well for

me, right? What if you could have, what if we could teach our kids that while feeling like they were enough, the denominator, they still could employ their passion, their skills, their interest into the service of others? If we find that balance, I think somehow you've hit that apex of the pyramid. That seems like the piece that so many people are missing. And within indigenous culture, we have this idea of Tomiuk, which is we look back seven generations at the people who brought us here. Those people may have been a part of World War. Two, World War I, they may have been hunter-gatherers, they may have survived like a grizzly bear attack. They may have been through things for you to be here today because we're all the

descendants of the people who survived. And we're supposed to live in a way that honors and respects their sacrifice for us to be here because we all have family members who endured something. And then we're supposed to live in a way that acts in the best interest of the next seven generations in a way that is balanced. And we are the lineage that holds the two together. And we have onus and obligations to both sides. And that seems like what you're talking about. Oh, that's beautiful. And that's because what you've just mentioned there, too,

takes the onus away from the me-centric nature that we all live in, this hustle culture, this mum boss, this all the thing that it's me, me, me, me, me, me. In some ways, we have got, we've used the word independent as if we've put it on a pedestal, that the best type of woman, and I can speak for that because that's who I am, is this idea that you are an independent woman when, in fact, the story that you're giving is this idea that dependency or this realization on the need for our other generations and the people around us is equally as important. So I think the more we hustle, the more we're just hustling towards a life of isolation.

And now we know where that's gotten us, you know? I agree. Do you feel like a lot of people are waking up to that reality? No. No, I don't think so. I think things like social media is great for, multiple things. It's what brought both you and I together right now to have these amazing conversations. But I think social media really still does fuel this idea that me, me, me,

work, work, get to where you want to go reach your own apex. And somehow whatever's left for everybody else, the dust that you leave behind is what's left behind versus that intention of I'm actually going to go out and do this in the service of others. And that's the only thing. in medicine that has brought me happiness. That is the only thing. Medicine has not allowed me to be creative. It's made me feel stagnated at many points, but feeling that I can wake up and listen to people's stories in the service of others is something that I, that's why I keep waking up. I have a hypothesis that although we don't like inflation, the rise in cost of living, although those aren't enjoyable experiences, they force us back together because when like,

You can think a hundred years ago when it was the Great Depression, we would have leaned on each other. We would have had to share butter, milk. We would have gone to our neighbor for sugar. We don't do that right now because we can just do it ourselves. And I think there is a piece that's been lost that we're a part of a neighborhood, a part of a community, and that we owe also certain responsibilities to give back, to support, to contribute, and to play a role.

And during moments like the 2021 Atmospheric River, we all remember people putting up sandbags. We all remember people coming together during these tough times, during COVID. That first month, man, that was beautiful that we were all going out there and ringing bells and, and kind of being together. And then so quickly that gets lost. And all we remember about it is, do we agree with how this decision was made or that decision? But during those moments of like, we were all afraid. We all didn't know what the future held. We came together.

And like it doesn't seem like we kind of put that on a poster. We kind of celebrate that after it's occurred. It's in that moment. and then we're on to the next issue and was this done correctly. And we kind of missed that opportunity to recognize the community we created during that period. And we're almost scared to. We're almost scared to linger on the positive because the media, the world is filled with so much negativity and indecision and destruction that if we allowed ourselves to realize the co-collectiveness of our human conscious and the way that we come together, it can feel a little bit overwhelming sometimes. So the negativity bias is exactly that.

that our brain is five times more likely to think of what's wrong in our day, what's not going well in the world to actually let us appreciate the times that we really did come together. But when we came together, we were vulnerable coming together. And that's something a hard time is a hard thing to reconcile. That when you really need each other, it's when you don't know what is going on for you and your family, then you start opening the doors and recognizing you've had this family live beside you all of these years and you don't even know their names, right? we've lost the sense of a village.

And I think more than ever, I talk to my mom friends who are raising young kids that no wonder we're all feeling so burnt out and overwhelmed. Our village, we are the village and that's not how we were supposed to raise our kids. One of the pieces that I think is a challenge for people is this idea of eating healthy because there's a responsibility and then it seems drab. But for a lot of people, it seems like it's moving in the right direction. We're talking about non-GMO. We're talking about organic.

we're talking about like natural foods, whole foods, rather than processed foods. It seems like we're moving in the right direction. But do you have advice for people who are like, I want to be healthier? I want to feel my optimal self and I want to put in food. I think we forget sometimes that like food is nutrients that is energy and we create energy out of that. And if you're eating too much, you're storing energy. And that actually slows you down and makes you less efficient and makes you feel less sharp.

Do you have advice for people? And I really want to be sensitive to the conversation, too, because when I talk to a lot of my youth, they actually want to eat healthier, healthier. I mean, the best definition of healthy for me is something that is naturally occurring outside and that wasn't processed or made in a plant. So the savvy way to say it is that don't eat plants, don't eat what's made in a plant, right? So that's what I tell my youth as well. And sometimes there are financial difficulties and burdens, especially for the youth where they don't have as much access. to things if their parents are the one shopping for them. But what I like to remind a lot of people of is cut through the noise. There is never, it reminds me of that game show deal or no deal, where they used to have those beautiful women and those briefcases. And if you felt like you just pick the right briefcase, then I would win the million dollars. People treat diet the same way. If I just pick the keto diet, the carnivor diet, the paleo diet, the this diet, that that diet, then that deal or nil deal, they'll reveal the sign and you've got your answer. It's not that way.

right? Take the best from all of these diets, which is always going to be, eat more whole fresh foods, eat less processed food. You know, eat at least a great rule of thumb that I give to my youth is one vegetable in the morning, two at lunch, three at dinner. Right away, you have at least your six there, right? Because we tend to just stack everything at dinner. For women get more protein, right? A lot of the times women themselves are feeling sluggish or craving carbohydrates because we're just simply not getting enough protein. So I talked to that with my patients as well. So I think a lot of that, just look for the similarities in the diets and eat what feels we all will have our own dietary discrepancies, you know, no dairy or no

gluten, whatever the case might be. But the two biggest things that I see people not doing enough of is getting enough high quality protein and not getting enough fiber. Forget about everything else, if you are eating foods that are rich in fiber, you're already way, you're already a full step ahead because most of the times food that's processed in a plant is not going to have the same quality fiber. Interesting. You were talking before about exercise and moving. And one of the pieces I liked was that you're looking for these moments, these moments of peace. I had Dr. Chris Bertram on and he talked a lot about flow states. And he's a flow state expert. And he talks about when you're running, you don't get a flow state when you're at two kilometers. It's usually once you've

been going and once your mind starts to find that like, okay, we're in a rhythm here and we're going to stay in this rhythm. And when I'm hosting these live events, one of the things I'm thinking about is giving people moments. They might not remember this, that, or the question that I asked here, but they're going to remember a moment of this. And that's another example of finding these moments where you're enjoying yourself. Things are good. You're proud of yourself. Like, we need to treat taking care of yourself like a responsibility. And you might not want to do the run, but once you do it, you're like proud of yourself. Like I actually did the thing I said I was going to do and I feel better and I'm not as sore and I'm not as cranky and I've let some of that stress and

energy go. But you also get these moments that you can search for too. Yes. Where maybe you go to the gym and you lift a heavier weight and you're like, wow, like I didn't think I was going to be able to do that today. And I was and I just, God determined and I followed through. How do we support people and looking at it differently, rather than a chore that you have to take care of yourself and you have to go for the run, that there are these opportunities to find yourself and find self-care and a sense of self-accomplishment through these moments. When I was going through that particularly hard time, I sat down, I never had been with a counselor before, but she sat me down, and she asked me a question, this is nine years ago, and I still

remember the question. The question was, when you exercise, how much do you need to exercise for it to make it count. And I knew the answer right away. And it was a weird. I thought, how do I know the answer to this? But it was in my mind 20 minutes. If it was 19 minutes, if it was 17 minutes, it wouldn't count. And I think that therein lies the issue. Even when you mentioned this idea of flow state, immediately I thought, what if a lot of people feel like, okay, I can't run three kilometers. I'm never going to try have a flow state again. You know those side of things. We need to realize that when it comes to exercise, when it comes to diet or nutrition, it comes to even being quiet or states of meditation or just calming the mind, anything and all of it

counts, right? We have to stop putting a fixation on, I need to run for 20 minutes or I need to go outside for 20 minutes to actually tick that box off. What if we started realizing that things like parking the car further or taking the stairs at work or doing what, they call it exercise snacks and they call it exercise snacks for a reason? Because you don't snack while you exercise, but the idea be that these little bursts of movement throughout the day, doing a plank, doing a wall stick, doing some low-impact jumping jacks, doing a couple of vinyasas if you like yoga, throughout the day can all add up. So let's start taking the idea away that it has to be for this long and start inserting little snacks throughout our day. And what you're going to find is that you're

going to start to find that you crave movement throughout your day rather than dreading a longer period of time. And I think those ideas of snacks throughout your day is a lot more, pun intended, palatable for a lot of people to think about. The other piece around exercise that I'd like your thoughts on is around the grit that you can develop. I do feel like people are a little bit softer, that people are a little less determined. And there's some people you may have heard of David Goggins, Andrew Huberman. And they've really said this example of like, no, you're capable. Like this idea that like, I don't know if I could do it.

Like, David Goggins figured out how to do like a marathon. And he had never run a marathon before. Like, you are capable of things that you don't even realize. And we underestimate ourselves so much. And I've watched people go to the gym and start to learn like, wow, like, I'm way stronger than I thought I was. And I had this expectation that maybe I could get up to 15 pounds. Now I'm at 30. And that's easy.

And you start to realize like, oh, I'm like my body is like something that's strong and capable and wants to do these things and wants to contribute. And we almost underestimate ourselves. Do you find that? Yeah, could not agree more. There's a beautiful book. I forget the author, but it's called Lifting Heavy Things. And it's got a little kettlebell on the title of the book or the page of the book. And it's all about how we can heal ourselves through trauma by exercise. It's particularly lifting heavy things. One of the things that you mentioned so beautifully right now is this idea of being uncomfortable, right? In the gym, let's not, if you're lifting heavy weights, you initially might feel a little bit uncomfortable. If you go for a run or a long walk the

first time, it might feel uncomfortable. One of the things that I strive to teach adolescence and that I needed to learn myself is that you were, there's 3,400 different emotions that we experience and we experience many of them throughout the day. Many of them are going to be uncomfortable and many of them are out of our control. We need to practice, being uncomfortable in a controlled way. There's a reason why things like stepping into an ice cold shower or having an ice bath or doing any of those types of things are a jolt to the nervous system because it's a controlled period of feeling uncomfortable. But when you control the level of feeling uncomfortable, you have that feeling of, oh my goodness, I actually can accomplish something.

No matter what my mom said, no matter what my dad said, no water, but all of these teachers who have told me I've never going to amount to anything using exercise as a vehicle for self acknowledgement, for being kind to yourself and realizing how far you can come. Because one thing that you can see in exercise that it's really hard to see in other domains of life is progress. Just like you mentioned, lifting a 10 pound weight, then a 15 pound weight, then a 17.5, you are never, your eyes are going to be open to that level of progress. So I use exercise a lot as a therapy for the young adolescent girls that I work with. I think our boys are doing a better job of hitting the gym or playing basketball or doing a sport. A lot of these times these young

girls, if they're not in dance or something else outside of school, they've given up exercise. So for me, part of the therapy, part of my counseling is to go into the gym. Don't just walk on a treadmill. Go lift something. Lift something heavy. And you are going to realize that you are so much more than everybody so far in your world has told you. you that you are capable of. And one of the things I liked that Andrew Huberman said was around this idea of the pump because your body wants to show you what you're capable of. And in the moments, like, you might go for a run and you might go from two kilometers to three kilometers. And like, that's rewarding. But that's maybe seven minutes of like at a time or something like that.

Where when you go and lift weights, you can actually start to see that muscle flare up and start to grow. And then you go, whoa, I didn't know I had that muscle. so many people will go, oh, I don't have a bicep, oh, I don't have any triceps. But when you start to see just even that outline, then you go, wow, I could do that again. And I'd look forward to that and I'd get excited about that. It's like your body wants to show you that you could go on this journey and that it just gives you a glimpse. And then you have to keep working to get it the second time and the third time. Exactly. And we were meant to move. We are species that are meant to move. We weren't meant to drive all day or sit all day or even stand all day in

terms of stand-up desk, we were meant to find ways to hunt, to gather, to move our body in a meaningful way. And talking, going back, looping back to the pharmaceutical company, there's this great joke that basically says, if you could package all the benefits that exercise can do, any pharmaceutical company would be dying to get that recipe, right? But you just can't, because exercise literally from your head to your toe and your mental and emotional health, the benefits are absolutely endless. So I think we just have to make it. more approachable for people and it's never going to be an all or none. I'm either a gym person or I'm either a gym person. Think of exercise like a menu. When you go out to eat, there's never just hopefully

a steak on the menu. There's going to be appetizers. There's going to be desserts. There's going to be salads and soups. Have a menu of options for your exercise that you like. Right now, I have a neck injury and a leg injury. So running for me has been off the table. But does that mean that I stop because I have Injuries? No, I go to my other options on the menu. You can find Zumba or dance or spinning or do other things that you enjoy. So start crafting your menu because injuries will come and go. Kids come and go. We have different times in our day. But try to make it so that your menu you can customize to you. I like that because you could also zoom it out and look at your calendar and say make a life that you actually want to live. Like you put in the meeting that you have to have and this like appointment that you have or

these pieces, but we often leave out like, what would you want for lunch if you could have the lunch you want? What exercise would you want to do if you had 20 minutes to do? Like, which one would you actually do that you wouldn't feel like somebody's forcing you to do? How can we create a lifestyle? Do you actually look forward to living where you'd give that to other people and go like, this is something to look forward to because it's got all the makings that you actually look forward to in your day, petting your dog, like put that into your schedule, like petting your cat, like doing these things, going for a walk in your favorite neighborhood or whatever that is, make sure you schedule those things in because it's so easy to just put in the duties. And then to, I only have five minutes

here and seven minutes here. So I'm just going to go to Tim Hortons or I'm just going to go to McDonald's or I'm just going to go here and skip out on making sure that you're living a wholesome life that you actually look forward to. And they call that time confetti, right? We always feel like we're worked with time famine, time famine, which a lot of us legit feel we are. But when the studies have looked at it, we actually still have a good amount of time. It's just broken up like pieces of confetti sprinkle throughout our day. So when you have the five minutes here and the three minutes here and the seven minutes here, even taking that time, now I have a time confetti list of things that I can do. And one of those things in my time confetti list goes back to the bottom of the pyramid.

You know, all those people that you see and you're like, oh, shoot, I wish I had sent to a text or kept in touch with you or I have a list of people that I reach out to. And I just put simply, you know, I'm just thinking about you. I hope you're doing well, right? So that way, the next time I see them, it hasn't been six months. And how nice is it to receive a text from somebody that hasn't spoken to you in a couple of weeks or months going that I'm thinking about you. So keeping a time confetti list of actually putting things that you want to schedule that bring you joy in your day is equally as important and allows you to set yourself up on the right track. Yeah, and doing weird things.

Like when my partner and I go on vacations, we often try and find postcards. and then we'll send them to the people we actually care about because it's like, how often do you get a postcard? How often do you get letters? Like, this is kind of a cool thing that we can do. We're out here. We have some time and we can just put time aside to kind of show people that we are thinking about them and we wrote up a postcard and we invested in the time to do this.

And then people go like, wow, that actually matters. It's not just like a quick text or like you can put, you can make it as fun as you want to. Like I find Christmas cards so often get like, they just write their name into a blank Christmas. card and it's like did you and it's a photo of their family like do I need this like I don't know if I need this but could you make it like interesting to the person where they're like wow you actually care about me like you actually value our friendship and don't get me started on the gift giving culture that's like you're giving a hundred and I'm giving 100 so let's just skip being kind to each other because why would we both waste our money it's like it's not about

that it's like can I prove to you that I know you and that I know you're missing something in your life that I could contribute that would make you feel value. But that takes time and it takes effort and even just that act of the postcard, which I'm going to have to use that for sure, is this idea that it's literally the gift that keeps giving because you've sat down, you've taken that time to purchase it, write it. And when that person's getting it, they're having a whole new experience of that as well too. So a lovely post that I recently wrote on LinkedIn was like, how can you be that box of chocolates in May? If you're a box of chocolates in December, nobody cares. I speak about this because in our office we get so many chocolates in November. in December and it's like they're just kind of puddled in a corner. We just got a box of chocolates and it was in May, June, and everyone went nuts. They were like, this is the best thing ever. I'm like, this is the same box of chocolate we could have gone to November, but it's this idea that you want to do it at the times when people aren't expecting it. And that's what's beautiful about the postcard. Exactly. Can we tie the last piece, the top piece of like, it sounds like

self-actualization in with culture and tradition and community because it seems like that's where, like, we can talk about culture and it's kind of hard to connect for people. But like if your grandmother made parochies and you learn how to make parogies and then you give it to your friend who doesn't usually eat pierogies and you go, this was the tradition for my family. Like that's a story that connects people. Like people get very excited within my culture when we do Banach. Like we host live events here and I didn't do Banach at the last one.

And I got a lot of feedback from people like, where's the banic? Like we really like it because that's not something people get access to all the time. And it's something within my community that. a member does, they do a very good job on, that connects and it has a story and people get excited about these things. And so it seems like self-actualization is also mixed in with understanding your culture, your community, the traditions that your parents and grandparents have and carrying those forward. And there's something meaningful about learning a recipe from somebody who's passed on and trying to understand where they were at. And why did they use

this food and this ingredient? And how did they get? Well, that was like more common back then and it's less common now. And so you start to kind of see the world through their lens as you're making this dish and reconnecting with their passions. And then you can share that with other people and sit around a table and enjoy dinner. And it's not just craft dinner and hot dogs cut on top of it. It's something that really, it's something to celebrate and get excited about again. And so what are your thoughts on self-actualization and how we achieve that in a holistic way? I think what you're speaking about is a sense of identity, right? where does that sense of identity come from in terms of your own achievement accolades what you

choose and how you choose to be and serve the world? And that foundation, it's almost like if you think about that plant growing up from under the soil, that soil is everybody like you talked about beautifully that came before you and that will come after you as well. When you're talking about this, I feel so nostalgic and in some ways sad because I think for me in my culture as well, I always felt like a bit of, I was kind of in a no man's land for a long time. Growing up where I did in the Fraser Valley, I didn't belong to, I'm not Sikh or, and I don't speak Punjabi. So that's usually the South Asian background. So I didn't feel like I was the right kind of brown that dominated there. And I certainly am not Caucasian. So I had to learn very early who was I. And my parents came from East Africa, from Uganda. They were thrown out with the exodus. And my grandparents came from Goodrath and India. And at, 15, there was a little ad in the paper, whoever read the paper back then, but I did. And it said, looking for people who love to cook. And I absolutely love to cook. And something that I was obsessed about is how to take Indian food, East African food, and make it more

westernized, more palatable and more healthy, right? So I pitched myself to the show, but not just myself, the four generations, my great-grandmother, my grandmother, my mom, and myself. And we all ended up appearing on not just that one national cooking show, but about three or four national cooking shows, showing about how our food has changed, evolved, and can be used in a more Western sense. And the best part was when my great grandmother was there all, kind of like this, lights, camera, everywhere. They'd flown in from Toronto. And she must have been 80 at the time. And this poor host is trying to fold a samosa. And she's looking at him, looking at him. And finally she goes like this. And she's like, you can't, you can't do it.

And then she starts folding the samosa. But it was this beautiful primal moment of this woman who's facing this Caucasian man trying to fold a samosa going, she's so proud of her culture, her heritage, and this idea of sharing it on national TV too. So I had to learn the hard way to not run away from my otherness, but to embrace it and take the time to explain who I am to people, you know, in our faith. we don't have a country. I don't have a country that we can say that is our country.

But we are a blend of a lot of different flavors and a lot of different cultures. And that's okay too. Yeah. My mother was a part of 60s group. So we were disconnected from our culture. And I think it's important to remind people that like that's your right. Like no, you can't tell other people how to be indigenous or be from your culture. Like that is your right of passage as a human being from earth that you're allowed to look back

at your family and practice those traditions that just because somebody might do it differently than you, we see that a lot with the language of like the Helcolomelamal language is people like, you're saying it wrong. Well, like, I mean, how often does a new word come out in the English language that wasn't you, like the word literally no longer means literally anymore per the dictionary definition. Like words change and evolve. But because it's a nascent language that we're trying to bring back, there's this feeling that you have to do it the right way. And it's other people's obligations on you that start to shape your understanding of who you are. But that's not the way it is. It's you have a right to that. Like you have the right to breathe and you have the right to go

find that culture and tradition and make it your own and then pass that on to your own kids and and continue that tradition in whatever fashion you like because it's yours. It's it's not something that has to be shared among other people. It's when you make dinner, how do you make it and how do you like it? And the people who are going to be judging you on that are not going to be at the dinner table every night being able to control how you view how you make your food and how you honor the people from the past. And all of that, when I talk to the youth that I do, sometimes they feel so lost. They've grown up in a household where some of them have told me that no one's ever told them that they loved them before. And that is a heartbreaking thing to hear. So sometimes

all I can leave them with is that the one thing you truly own is your story. And I think that's what you're getting at, this idea that your story for everything that you've gone through, everything that are going to do in your life and everything that your culture and your experiences have taught you, that's what we need to leave our youth and our adolescence with more than anything, is never forget the importance of your story because no one will ever wear it like you. Do you think that millennials and Gen Zs have lower stress tolerance and resilience than most? I think it goes back to that understanding of the adjective versus the noun, sometimes feeling like we need to medicate everything, sometimes being.

so afraid of because suddenly now post-COVID, it's wonderful. We're talking more about mental health, but the minute I mention anxiety or depression, they're like, oh, my word, you have a diagnosis. And it's not the case at all. So resilient is a hard word. I've met youth that are more resilient than I will ever dream of being in my lifetime. They have had so many adverse childhood experiences and are still here sharing their story as well. But I think it's how we frame our mental health, and it's allowing our adolescents to realize is a situation manageable or unmanageable and stop robbing our kids from making mistakes. Let our children make mistakes. Learn to fail. Failing is completely okay. The acronym that I use for fail is finally an important lesson.

Finally an important lesson. Because I lived most of my life walking the plank of don't make a mistake, don't make a mistake. And then finally, after I graduated kinesiology, I got into medical school, said no to medical school, went to chiropractic school with my now husband. It was a $60,000 mistake. No, I love chiropractors. I'm married to one, but it wasn't the right profession for me. So went back to medical school, tail between my legs, and it was one of the most important mistakes and failures I've ever made. So remember, finally an important lesson.

1.6 million children in 2023 struggled with mental health and finding treatment for it. How do you think we start to address this? I'm going to give a very unconventional answer. The way we start to address this is by the health of those who are addressing it. Now, let me explain. Right now, I work within a school system at an alternate school. I'm a physician on site. I'm also a part of the foundry.

so I find myself very well immersed in this. You are going to have people who are peer supports, youth workers, parent supports, who are literally on call for these youth 24-7, some of our most at-risk youth. And you go when you ask these youth workers, who's taking care of your mental health? Are you seeing a counselor? Do you even have funds to see a counselor? And the answer is no. So how do we employ taking care of these youth if the people who are literally putting their

life on the line, putting their families on hold to answer these youth's call at 2, 3, 4 a.m. if we are not taking care of them too. Having better access to more, to social workers that will follow through on what they say they're going to follow through on. No offense, I think social working is an incredibly distinguished important career, but the burnout rate is also incredibly high. So what you have is this turnover of social workers who are trying to help a youth. And every couple of months, it's a new social worker, so nothing ever gets done. So yes, we have to focus on the youth, but we also have to focus a lot more on employing and taking care of those people

who are changing their life in order to benefit our youth. We employed a lot of different approaches during the pandemic from 2020 on young people. What do you think the impacts of the pandemic were? One of the best things is that it got us talking about mental and emotional health. One of the worst things was it contributed to a level of isolation that we've never seen, probably and hopefully we'll never see again. And that isolation, the effects of that social isolation are really hard to undo in our youth because they were happening at such a formative time.

So you imagine those, that two, two and a half years of kids who are out of the school system, who were just at home on their computers, really just growing up by themselves and now trying to reintegrate them, I'm not a teacher or an educator, but I've talked firsthand to the teachers that I've worked with and they say that those were now coming out of it, two of the most difficult years to teach and to educate as well. So I think the impact that we need to start to unravel is what is happening with the isolation in our youth. And luckily for places like the foundry where we bring youth together, where we have programming, where we can see youth in person, we were just talking about this too. Doing a podcast on Zoom is great.

Doing it in person is a completely different feeling. So I think that's what we need to strive more of doing in our youth. Your book, Feel Better, comes out September 2024. Can you tell us about it? Thank you. Yes. So this is my love letter to the youth. It's the stories that they have taught me translated into lessons that we as adults need to hear. So sometimes people will always say, well, thank you for all the service you're doing to the youth. And I'm like, well, no, I need to thank them. Because when they are sharing their stories, I realize how many things that I'm missing

or that I've misunderstood, the feel better approach was born because of a youth who told me, I absolutely hate myself and he used many other expletives that I don't need to go into. But because of that, I realize that how can I ask my youth to be aware and self-aware like that water bug on the surface of a water if they don't acknowledge how far they've come, acknowledge their progress, and acknowledge who they are in this world. It's really hard to be self-aware. So the feel-better method is working on self-acknowledgement, self-awareness, accepting how you feel, not suppressing it through a Starbucks drink or through Netflix or through three glasses of wine and then action. What are you going to do? How are you going to actually take the clues that an

emotion is giving you and use that as a compass to find out what you truly care about? So that book's coming out in September was written alongside Adrian Gostick, who's my mentor and New York Times bestselling author of The Carrot Principle. And I'm forever grateful to him and his son, Tony, for shepherding me through a very long process. Shahana, how can people follow your work on social media? So come check me out on my website, Dr.shahana.com. I'm very active on LinkedIn. I enjoy posting there almost every day.

I have a ton of videos on YouTube with all of this information and more, as well as Instagram. Fantastic. I really appreciate you coming out today. I really prefer the in-person interviews because I think we can start to get a flow going in the conversation. I think you have a lot of good metaphors for people because it's so easy to say the thing people need to do. It's hard to make it digestible for people where they can start to see it applied and see it out in the world. And the one thing I love about indigenous culture is so

many of our lessons are written on the land. And we have stories about the mountain and how it treated another mountain and how they were once sisters and how they worked together. And we have these stories that we can start to draw lessons from. And I think as a lot of people look at religion and see maybe that's not for me, we still need those lessons. We still need things to guide us and we need it to be digestible. And I think you're very good at doing that and getting us excited about the ideas of taking care of ourselves so that we can support others and be the difference in our own community. So I appreciate you for all of that. Oh, thank you so much. This was an amazing conversation. The time just flew by. And I really hope when people listen, they can walk away with

one, two, or three things that they can keep with them in their hearts. I'm sure they will. Thank you again. Thank you.