How to Cultivate, Maintain, Regain Mental Well-Being

HMNews: What cues let you know that you’re feeling emotionally overwhelmed?

Larry Weru: Some are subtle, some are not. I can get anxious, and that’s very obvious when it happens. If I’m stressed out, I think I can pick up on some of the cues. I notice that my heart rate’s increasing.

I notice that I’m not being as productive, but that’s more subtle. I like to track my time and figure out how much time it’ll take me to accomplish things. It comes from my doing a lot of e-commerce consulting for the past couple of years. You estimate how much time it’s going to take to accomplish things, you send a quote to a client, and your business will succeed or fail based on your estimates.

So, you have to get really good at estimating, and I take that into my schoolwork. If something has taken me way longer than I expected, I ask myself what’s going on. Am I not as focused? Do I need to just pause and do something else now? Do I need to just go for a walk? Do I need to get some food? Do I need to go do something fun? So, noticing if I’m not being as productive.

I think it’s easy for us to not notice our emotions, and we don’t notice that they can shift. So, I ask myself how I’m feeling and then find the answer to the question.

Vikram Patel: For me, the most important signal is irritability. Everyone has their own signal. When I’m short with people, and I feel this anger bubbling just below the surface, I know that something is bothering me and I need to figure out what that something is. Anger ultimately always makes me feel worse. Not only because anger itself is a very destructive emotion, but because through my anger I hurt other people and then I regret it.

The second is a feeling of dread, a deep feeling inside you that something awful is going to happen or go wrong. For example, a project will not achieve the goals that it was supposed to.

The third is rumination about what might have happened. I find that deeply destructive because, of course, you cannot change the past. What if I had done that? What if I had done the other? What if in my personal life I had made this decision?

All of these three are cues to me that I have to step back and ask myself what is triggering these negative emotions. Because each of these has a story of its own, and each of these will actually make the situation worse, not better.

HMNews: What do you do — or who do you talk to — to get a handle on uncomfortable feelings?

Mary Barber: One powerful message that yoga taught me is the power of breath. The first time I experienced the loss of a patient in the pediatric ICU, I relied on deep, intentional breathing to handle my feelings in that moment. My go-to breathing exercise is to inhale, then hold, then exhale, each for a count of four. I also love using a mantra in these moments. My personal mantra while deep breathing is “I am strong, even when I feel weak.”

When I carry these hard emotions home, I turn to physical movement. I love to ride my Peloton bike, do some yoga, or go outside to get some fresh air. A big part of my routine is to talk to my support system, such as my husband, my family, or my friends. I will say a prayer for God to give me peace in the moment of hard feelings, and the help of a therapist has aided me in discovering new additions to my routine.

Self-care has become so important to me because I realize that to be the best I can be — as a doctor, learner, advocate, leader, wife, friend — I must care for my own body and mind first.

Brian Crete: I allow myself to pause, reflect, and renew whenever it’s required. Most of the time, taking a long walk or drawing for a bit will give me the head space needed to process and breathe through the feelings. Other times, I will talk with my partner, friends, or family to get their shared experiences or perspectives to better understand what the issue might be.

And sometimes, seeking out the guidance of a therapist to talk through a reoccurring challenge and to help identify new habits has been a transformative resource. Even my dog plays a role, especially when I want to talk something through without getting a response, and her genuine cuteness always makes a bad day better.

Dee Jordan: I started listening to myself and realized there is absolutely nothing wrong with needing a break.

So, I close my laptop and go eat, nap, walk, exercise, laugh, watch something, or read a book. I’m no longer afraid to pause, to take the time I need. It’s bold for me. I had to learn to be OK with taking a break because I naturally put too much pressure on myself to achieve. I had to come to terms with me and tell myself that I don’t have anything else to prove. I am enough.

Once I got that message, I started loving me even more. I chose this highly productive, competitively prone lifestyle. But If I do nothing else, it will be OK, I will not cease to exist. The work I have already done will hopefully continue to help transform knowledge and impact lives. I will continue to give of myself in service to others, in advocacy for others.

The death of Paul Farmer revealed to me that despite the loss of a great luminary, the machine of the academy keeps moving — it doesn’t stop for any of us. We have to listen to our bodies, take time for ourselves. So that we are fully present to engage and make an impact in our spheres of influence.

HMNews: How do you feel about acknowledging your mental health needs?

Mary Barber: For the longest time, caring about my mental health was something that happened organically, unconsciously. It wasn’t until the combination of stressors around the pandemic, caring for patients, increasing responsibility, tragic personal loss, and seasons of change came together in a critical mass that required more intentional, thoughtful work.

There is still a lot of stigma around mental health, especially among the high achievers in medicine, but that doesn’t make addressing one’s mental health any less pervasive or important. By acknowledging my own mental health needs, and opening up about my struggles and triumphs, I’m inviting others to do so as well, with the hopes of creating a community that thrives on honesty, transparency, trust, and support. If sharing my journey helps at least one other person to feel encouraged to open up about their own mental health, perhaps for the first time, then I believe it is worthwhile.

Larry Weru: When we get sick, we go to a doctor. But when we have mental health concerns, do we go seek treatment for that? Oftentimes we don’t. We might feel like it’s not an actual illness that needs to be treated; we might feel like it’s something that we can just get over on our own.

There is a responsibility on those of us who know what needs to be done to increase awareness of mental health issues. And I kind of feel like that’s what Harvard’s doing, even with this story. So that’s really awesome.

I can get a doctor’s note to say please excuse this student who has a bacterial infection or the flu. But if somebody was going through a very tough breakup, which can be very mentally and emotionally taxing, is it the same?

If you tell an instructor, hey, I’m going through a bad breakup, can I get an extension? I’m not sure that would fly the same way as, hey, I’ve got the flu. You know? So, this is an important conversation to have, about how seriously we take mental health and all the different flavors of it, and when it needs treatment or just needs self-care and doesn’t necessarily need any kind of medical intervention.

Interviews were edited for length and clarity.