Checking In w/ Dr. Sue Varma

pre episodes. They have been so fun, so so positive, so affirming, and it kind of lines up with our guests that we have today. I'm sure you've seen her as an expert on the Today Show or Good Morning America. She's an author, psychiatrist, New York University medical professor, a two time sharecare Emmy winner. Please welcome doctor Sue Varma to Checking In.

people coming in. And it would be a few years later when I got selected to be the medical director of this program and started getting very interested in resilience because Michelle I was seeing that there were all these people who would come in and some of them had medical problems. They were covered that day with dustin debris as they were trying to escape, a lot of them

got trampled on. Some people witnessed loved ones just getting trapped, not being able to get out, seeing people jumping out of the windows, like just all the worst terrific, unimaginable stuff. But what it also taught me about was how the human spirit truly is resilient in the face of adversity, and really it's through helping others. That is where I

saw some of the strongest people. Not that they didn't have their own injury or illness or problems or job loss, but somehow they in the midst of all this, they were able to rescue other people, pick up the people that were trampled on. And then these were the folks that kind of went on to to survive and not just survive, but thrive. And so I got interested in who these people are, what are their genetics, what have set them up in life? You know? And then how

can the rest of us learn and take notes? Because up until now, you know, Michelle always thought of like optimism as something you were either born with or you weren't. And then what do you do if you're not? What do you do if you're the glass half empty type? Because all of us know people like that, right, Like, so it was like, all right, how do we figure out what do these people have who are just naturally positive? And then how can the rest of us learn from them?

support themselves, people who have a sense of humor. Like, think of resilience as sort of this umbrella and then underneath it that they're all these little things, and optimism is sort of one of the key five or six things that all feed into resilience, and up until now nobody really paid attention because they're like, all, right, social support, I can work on, I can try to learn how to ask for help, right, I can kind of reframe my negative thinking, maybe with the help of a good therapist.

But what is this optimism nonsense? Right? Like, it's like either you have it or you don't. And if you don't have it, First of all, if you have it, are you like we were talking about toxically positive, Like yeah, all figured itself out? Or are you just negative? And then there wasn't nobody realized that it was something actionable, that optimism is a skill, that it's a tool that it can be learned, it can be taught, and it

can be practiced, and our life depends on it. Because there is so much robust study that shows that people who are optimists, so you know, if you're blessed to have these genes, you can benefit from it so that you live longer ten to fifteen percent longer. Optimists are healthier, they make more money, they have longer lasting relationships. So there's so much robust science now and data to back up the benefits of optimism. But up until now, until this book, no one told us how to do it.

And so that's what I'm saying.

And that's what optimism is is, in any number of possible outcomes, you always envision, imagine the more favorable one. People who aren't born with this gene or a variant of it, have a tendency to pa negative thinking and depression. But to me, the more interesting part was not which gene you were born with. What was the fact that people who had this optimism gene, so to speak, had specific skills, so they were more likely to ask for help.

They were better at regulating their emotions and coping skills. And I was like, I'm already doing this with my patients, right, but I'm doing this with patients who've already gone through trauma the other shoe has already dropped, so to speak, and who have come in asking for help, the big tea of trauma, life threatening type of thing. But what about all the little teas, the everyday the disappointments, the job loss, the breakup. What about that? What about those folks?

They may not have a big enough quote trauma to bring them into help, some of them because they have stigma and barriers will never come to seek help. How do we take what we learn about optimism the genetic kind and then turn it into a set of practices, because really, that's what the researchers found, is that there are skills that optimists do. It's not magic. It's really not magic. Some people are just gifted and they're born

with this natural tendency, right. But really, what you find in the brain when you do brain scans is that people with optimism, they have more activity in a certain part of their brain, in the left part. Yeah, so you can see. So if I gave you an exercise, and if you're an optimist, you're gonna be like, I show you a picture of a car accident. Na, na, Na, They'll get fine, they'll get medical treatment, we'll go back

to work three days, three days. The pessimists will see the same thing, and they're going to have more activity in the right part of the brain, and they're gonna be like, Nah, they're not going to get better. It's going to take them three months. They're not going to walk, their wife is going to leave them as a result. Like, they'll just project the worst case and you can see it on their brain scan.

And it could be your parents getting divorced, your parent not getting treated for illness, your parents fighting a parent, leaving a parent, getting anything. And all of us probably have at least one of these, and you know something something, everybody's got something. So pessimism can come from your parents having experienced trauma and it's already kind of baked into your own genes. It could be the mental health history in your family that there's people in your family that

have depression and it's been passed on to you. And then the cards you're dealt one hundred percent, But the thing is in spite of all of this what we call genetic loading. That you might have had a family history of pessimism, of depression, your own history of trauma, you can still change the way you look, because when you change the way you look, your life changes, your

outcomes changes. And that's how optimism differs practical optimism, because it's not just having a positive outlook, it's turning those positive outlooks into positive outcomes through action.

She's had depression, her sister had depression, but I feel like it was situational because she had a child that was still born. But we looked at my father and she admitted that it's a possibility that it had he been diagnosed, him and his.

to bulled maybe that can make a child depressed. I would love for you to just help us unpack I guess what I'm talking about, especially talking about depression so young in the seventh grade, but the whole genetic piece of that. Yes, you know, I said a lot by the way.

things are incompatible with each other. They almost put people in two buckets, like you're either successful or you've had depression, Like they don't put it together them successful people often live with depression and it's and and all the success they achieved might be in spite of it or like working really hard to fight it or to not let it take over. So thank you for sharing that. And yes,

so you know it's very interesting. Depression is a very complex illness in that now we're getting more understanding that the inflammation can be a part of it. So like our things like our diet can play a role. Exercise can help boost and kind of mitigate some of the symptoms of depression by increasing dworphans in the brain and

serotonin and certain chemicals BDNF brain derived neurotrophic factors. So there's all these things that can help us kind of like fight against this maybe genetic predisposition, because when you're talking about untreated bipolar disorder in the family, bipolar disorder is highly highly like what we call genetically like transmitted or heritable and like passed on and from parent to child.

And what we also see is that people who have bipolar disorder in the family often will also have first degree relatives, so like a sibling or a child which has just straight up depression unipolar depression, like bipolar is both the mania and then the low the high highs and the lo lows, and unipolar is just the lows. So definitely, it's like it's like for you, like it sounded like hitting from both sides, Like you know, you've got the dad and the grandparent and the mom and

your mom's sisters, so it's understandable. Like the likelihood or the chances of the child having it if both parents have had something in the form of a mood disorder is absolutely very high. And then you add in environmental pressures of the like the bullying, which is very damaging, like bullying one percent increases your risk for all sorts

of problems like anxiety, depression, academic challenges. Because Michelle, one of our fundamental needs as human being is belonging and knowing that we matter to our peers, to feel like we fit in and to feel like we have a place in our society and in our community. And so absolutely there's no reason why a seventh grader couldn't have depression, especially if it's in the family.

you are the pillar in your community. Right, So, like when I think about like moms and aunts, they're cooking, their home is open, people are coming in, and like you don't even get a minute. You don't have the luxury of being depressed, Like depression can be seen as a luxury sometimes, right, Like you know, get up, pick it up, move it. People are relying. You've got kids

to take care of. Like, so I feel like there's a lot of layers and culture plays and ethnicity plays a big role in this whether you're allowed to even be depressed.

this affects our biology. When we're experiencing that we don't we're not made to feel like we belong, whether it's on a cultural level, maybe it's the color of our skin, or we're just bullied because for no reason, and all of that. I put that in a similar bucket where it starts to chip away at our morale, you know, and something like nine to eleven terrorism can do that. It chips away at your morale, your sense of safety. You're like, you feel threatened, someone is out to get me,

someone doesn't have my back. I'm not safe, I'm not protected. People don't like me. And however you want to call that, whether it's bullying in seventh grade, or whether it's like I'm a woman of color moving in the world and the world doesn't see me as equal to them, you know, any number of things, and I feel like when you look at people's chromosomes, what we find is that there's more stress. They're telomeres, which are the ends of the chromosomes.

These pieces end up getting oxidative stress, and they end up becoming shorter, and it makes our biological age older than our actual chronological age. So like if you're thirty thirty five, yep, you and if someone looked at your chromosomes, I'll be like, you look like a fifty year old. Like on the inside, Oh.

that oxidative stress. So they found moms. They put young moms who are undergoing a lot of stress, and they put one in like a control group, and they didn't do anything for them, and then they put another one in like a meditation mindfulness group, and those women, over time showed a younger biolog like comparatively to those who did nothing, a younger biological age because the meditation protected them.

So just because they are all these forces and factors, and it's understandable why people are feeling down these days, like inflation, war, right, like our country is, you know, strife. There's so many things happening politically. We don't feel protected and safe by and taken care of by our leaders. We don't have health care as a basic we don't have education as a basic right. Like to me, the marker of a humane society is providing people their basic needs.

And when we look at like the World Happiness Index, who are these top five countries? Who are these top ten? The Scandinavian countries are always winning because women have rights, right, they have positions and boards. So you can't have half your population. If half your population as women be neglected, left behind, not being given options, and then you don't give them healthcare on education, look like you're screwed as a society, you know. So I'm like, I'm pretty impressed.

I'm pretty impressed that Americans for the most part, are optimistic. Of all countries I heard that like certain parts of the world where women don't have rights, you know, the optimism and the hot happiness fall, like in Afghanistan, they are like the lowest on the happiness index, and happiness and optimism are not quite the same. But this idea that I have hope for better tomorrow, right, Like, I'm impressed because I feel like, generally speaking, maybe compared to

other countries in the United States, we do women. You know, I feel blessed enough, even coming from an immigrant family, being a woman of color. Yes, I'm still grateful for whatever opportunities I've had that I know I wouldn't have had in other places. So as much as there's wrong in this country, there's also a lot of positivity and right So we have to balance it the good and the bad.

supposed to have, you know is a right. So I'm with you when you say you can understand why there's no optimism, there no happiness there going through the motions, which was a question that I have for you a little later, So say what we were just talking about women in certain parts of the world world who don't have rights, or people in America who don't have access to healthcare and education, but you're told that, no matter how dire or difficult a situation is, you should maintain

a positive mindset. And this is coming from verywellmined dot com. They were talking about toxic positivity, why it's harmful, and what to say instead. Well, we're not going to go through that anyway, but so for those of you listening, you're like toxic positivity. So toxic positivity apparently is the belief that, no matter how dire or difficult a situation is, people should maintain a positive mindset. But in this article,

it's saying that it's toxic to always think positive. So as we're talking about you don't have health care, you don't have education, you're living paycheck to paycheck. I was serving at a food pantry in Florida a few months ago, and there were people that had what you would consider to be newer model cars. One woman said, I work at well, she works at a certain delivery logistics company, and she said, I'm still living paycheck to paycheck and she's.

and that makes them feel dismissed. And you know, toxic positivity is telling someone to look on the bright side without really understanding the gravity of what they are going through and with out validating their experience. So a more helpful statement would be to acknowledge the hardship, to say, like, I see how hard you're working. I see how challenging this is. This must be extremely frustrating, and at the same time so recognizing the reality of the situation, which

can be quite dark and grave and devastating. Like sometimes when I have patients who tell me something really horrible that has happened or happening, Like if I were to be like, yeah, man, just get over it, that's not going to work, they'll be like, you know, peace out, I'm not coming back to you. What do you mean, you know, just get over it, right, So you have

to sit with them and grief. Grief is not just about the things that you've lost, but there are also the things that you never gained, maybe the milestones in life, like during the pandemic, people didn't get to celebrate a graduation, a retirement party, or they didn't get to say their last goodbye to a loved one who might have been in the hospital and dying. Right, So it's not just things that are lost, but it's also things that you

never had that you wish or wanted. So what you're talking about, Michelle, like the sort of paycheck to paycheck life, like,

that's that's where we're at. You know this, The studies show that even people were making like a fit let's say family for household income is like two hundred twenty five thousand these folks, which is triple the meeting income in the United States, they still can't make it, you know, sort of day to day And when I look at like private for example, when I talk to people who are in Europe and they're like, oh my, I went

through this fabulous education. I only paid like, you know, the equivalent of four or five thousand out of my pocket in Euros the whole year. And they're like, you know, in the United States, this would have been an eighty thousand dollars a year undergrad tuition, And I'm just like, there's no world in w which our undergraduation should be

that kind of money. That is like serious money, and it just makes me sad, and really hard working people just you need to catch a break so that you can get out from underneath debt and you know, and be able to get to the next level. Like you, if you don't have the backing, you're not even going to be able to get the education that might help you move to the next level. So you know, it's

not an easy thing. But at the same time, I say, like, don't give up hope, Like practical optimism is about Okay, if Plan A isn't going to work, I'm going to go down the list to Plan b CD all the way to Z. You know, can I get a job that can have let's say, as one of their benefits tuition reimbursement, college loan forgiveness. Are they willing to pay for night school? Is there a course that I can take? Because a lot of times I feel like we also

put walls up. We don't want to admit that we're struggling, you know, whether it's financially or job wise. And I feel like that's kind of where we get in our own way, where we're not asking for help because we don't want to admit to somebody else that we look

like we have it all put together, right. We've got the newest iPhone, we've got the fancy cars you talked about, like the designer, right, so when we look head to toe, nails are done, all of that, and inside we're like, oh man, I don't I don't know if my bank account is going to bounce, you know. So it's this idea of like maintaining appearances that that really scares me because not only you're doing yourself a disservice financially, but also mental health wise.

what're putting on? A strong face is not the worst thing in the world, because it means you you pick yourself up, you doust yourself as you know, I'm telling I'm telling you know like that that such a beautiful line, you know, like from you know, I think it was a Oliah.

Optimism for me has been the track record, meaning have you gotten through heartbreak? Have you gotten through financial stress? Maybe you say you got through financial stress because maybe you're like you're stewarding the finance is better. Maybe you're ordering less on certain apps you know, you're you're cooking more so, or you're just trying to optimism in the reality of what's going on. I just want us wanted to just look at a circumstance and be like, I can be opts domistic.

you want from me. And I'll be on my couch like the rest of us and they're like no, no, no, So you're going to come on and talk about something positive and hopeful and then give people strategies and yaha. And I was like, oh great. So like I have an hour and they're like no, no, you have fifty nine seconds. And I was like fifty nine seconds? How

am I going to and carry? Washington was actually introducing me, and I was like fifty nine seconds first of all to follow her and I love her at work, and then I was like, okay, well what do I say that's going to add value? And that's where I came up with. I was like, okay, in fifty nine seconds, if I could impart the CrOx of what good mental health is. So, look, it's not going to substitute therapy, the individual work that's done one on one when somebody

really investigating to know you. That's not going to take the place of it. But what do I tell my patients? So even when they come to me and they're like, oh, I went through a job, books, I went through divorce, I'm still taking a three sixty inventory about their life and I want to know about their diet and their habits and their friendships. So if I had to break down good mental health in fifty nine seconds, and we have a few more mindmentes of that. But meaningful engagement

is my favorite. What I love about that is telling people there's two levels of relationships. There's the social snacking, the micro connections, which is like the barista, the dog walker, making superficial connections. That is just as important. The activity partner. Maybe have a friend that you go cycling with or go to a power yoga class with like that is

totally okay and necessary. Activity partners. We need those. You're at work, the water cooler, at the elevator, talk to people, make eye contact, smile, ask them how they're doing, Listen wait for the response, say something meaningful back, or just say I hear you. You know if you don't know the right thing. So that's social snacking. That's the micro connection. That's part of meaningful engagement. But also I want people to go deep, have the one on one sit down,

how are you doing? And then be real take the mask off, because so many of times we're posturing and posing. Everything is great, my relationship is great, my money is great. This is the biggest If I were to be like, what is one of the biggest causes of unhappiness. It's this need to seem like we're successful and that we have it all together, and that is getting in the

way of real, authentic, honest conversations between people. So go deep, be vulnerable, share something about yourself with the trusted people in your life, and then also have your light fluffy activity partner. Social snacking, micro connections, mindfulness. Just do something one at a time. If you're talking to someone, that's all you're going to do your washing dishes, that's all they can do. And make should listen to your podcast, by the way, so you know while they're doing something.

But whatever you do, do it wholeheartedly. Do it meaningfully. You know, if you're going for a walk, be in the moment and walking by the way is a great way to get out of your own head because it's something called optic flow where you have to look left, you have to look right, make sure no one's running over you with a car, and that gets you out of the rumination in your own head. But mindfulness could be deep breathing, it could be meditation. There's so many

benefits of meditation. So we've covered meaningful engagement, we've covered mindfulness. You know, I would say part of mindfulness. I was interviewed earlier in January by the New York Times by a well wellness their wellness section, and it was called Oasis moments. So it's about taking five minutes maybe have a little meditation corner, a little zenden in your home if you will, put a little cushion on the floor and create a sacred space where you're just gonna breathe.

It could literally be in your bathroom. Like I'm a mom and when my kids were young, it was the only place where maybe maybe two minutes, they would let me just be because but pretty soon they'd be knocking, you know, soon. But the bathroom floor was kind of my zend and it sounds kind of funny, or medical training, the utility closet, like I'd be like, I'm gonna go get those needles and the I'll be right back, and I would just go in there and breathe for two minutes.

So mindfulness can create. It's about intention and creating a sacred space of just going inward and breathing, or if you're talking to somebody or whatever, just doing it single mindedly. And then there's mastery. And I did two days. It was a six day well challenge with the New York Times. In the sixth day it was a Friday, and they're like, we want you to bring or the fifth or sixth day was the end of the week, and they're like, how can people unwind without turning into you know, digital

or watching or streaming. And it was called low stakes flow state where mastery you don't have to be a master to experienced mastery. They asked me how do you experience mastery? And I was like, I'm not very good at it, but so all said dancing. And so for me, like in medical school, it helped me, like you know, I've been like shaking it to like Mark Anthony and

I love music. Your music, like just music helps me just live and be happy and kind of get that out of my own academic intellectually, you know, be with people, and I love music from that part of the world. I feel like it's just very uplifting and yeah, so

flow and mastery. It could be cooking, it could be gardening, it could be painting, it could be a lot of people into weaving and needle point like all of that sort of creative making something you know and you don't have to be good at it and it doesn't have to be for anyone else but yourself. And then the last one is movement. And this can be in any form, but we do know that exercise not only does it boost your mood, but it also boosts your sense of

purpose in life. So if anyone's listening to this and they're like, I don't know what I want to do. I don't really feel called to do anything big. I'm bored, I'm lonely, I'm feeling empty, I don't know I want to make a career pivot and I'm not feeling inspired. Go for a workout, thirty minute workout, do whatever you can weightlifting for women is great. It decreases like again, it boosts your cognitive health cortisol. Yeah, totally decreasing the cortisol.

And you know what's really interesting is if you're like, oh, I want to be mentally sharper, right after your exercise is the best time because your attention, your concentration, your memory, everything is boosted. So maybe leave the most difficult task.

If you have a really annoying email to put together, or a project that you're like, I need creativity and they don't have it, schedule a workout session and immediately afterwards, like bring your laptop, and if you're lucky enough to be at a gym or wherever it is, you are just hit that most difficult to do less task right after exercising. So those are the four ams of mental health.

pouring to us about the importance of being optimistic. But at the same time, you know, not dismissing your reality and how you treat people who are.

I'm better. I've been through you know a lot myself personally, and I talk about in the book in fact, it's the opening chapter of my own personal breakdown, if you will. And then how I came to learn about therapy, you know, and how that's made me a better therapist, and how that's made me a better person, you know, and like

all of the things that I talk about in the book. Yes, I wanted to make sure everything was science backed, and I did tons and tons of research, but I also didn't want to put a single thing in their book that I haven't used on myself and practice on myself

and with my patient. So the four ms of mental Health, I think of it as a prescription and back in the day when we had prescription pads and doctors used to write them before we went from to electronic, I would write on my pad, you were going to exercise, you were going to you know. I didn't have the language of the four ms of the time, but it was. It's now like a non negotiable for me, like I am going to finish with you and before I see my next patient, I have a little time and I'm

going to run to the gym every single day. It's non negotiable. I'll pick up the phone and call a friend. So I put them in my life. You have to schedule, think of if you take nothing else from this conversation, The easiest thing to walk away with today tangible tool and tip is the four MS Mindfulness, Movement, mastery, meaningful engagement, And just populate your calendar with when am I seeing a girlfriend in person? When am I going to go to the gym? When am I going to go for

ten minute walk? And I hope that your mom listens to this conversation and is like, all right, I'm putting that neon vest On and I'm putting those bright sneakers and I'm going because if I can share with you. My mother in law is beautiful, lovely, very healthy, healthy, very youthful, but like it's is also like I got

to push her. She lives across from this beautiful park and is in driving distance ten minutes to the beach, and those are two things that I love, being in nature and the ocean, and I can't get her to go. And it's like maybe sometimes people take it for granted when they're surrounded by beauty, you know, And I'm just like, please, like your health and your life depend on it. So I know what it's like to love someone and to care about their well being. I went through this with

my mom as well, and it was really hard. Like you can have all the knowledge in the world, but if like somebody in your life isn't ready to absorb it, Like you know, sometimes you feel like, oh my god, I'm bangging my head against the wall. But I'm not going to give up because I'm a practical optimist. I'm going to keep trying. And I hope you keep trying with Mama Williams over that.