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E#187 How Exercise Improves Mental Health with Zac Jefcoate

This episode is about how exercise improves mental health with Zac Jefcoate

Today, I interview exercise physiologist and health and wellness coach, Zac Jeffcoate to discuss the links between exercise and mental health, the cost of prevention versus injury management, and how the powerful combination of individualised exercise and coaching can empower improvements, save money and improve quality of life at the individual and workforce level.

MW: I’m pretty interested to start by hearing a bit about what you’re really passionate about.

In this episode, I’ll talk about 
* The links between exercise and mental health
* Why changes are difficult, and how to overcome resistance
*  How individualised coaching and exercise programs can improve health and save money
* The importance of simple steps

ZJ: Well, firstly, that question gets asked a lot, and the way I answer that is, the passion for me is providing exercise and movement. Initially in my career as an exercise physiologist, we can impact people’s lives really positively. And as I progressed in my career, I found that it’s not so much what exercise does, but it’s more the fact of what exercise, obviously, how it improves the quality of life, and how people actually fit that into their day to essentially get to an outcome.

So my passion is actually educating people on the benefits of exercise my solution and what I kind of not sell them what solution is that exercise is a modality that fits into their lifestyle.

And it’s really important that we look at how diet, sleep, exercise, relaxation, and meditation fit into a physical mental model. My passion is really the profession, I’ll be honest with you. It is exercise physiology. And beyond that, it’s obviously providing education to anyone who wants to hear.

MW: Wow. And it sounds like you have quite a broad experience. We were talking just before we started this conversation about all of the things that you’ve done. Can you give us a quick recap of your world tour of Australia?

ZJ: Yeah, well, just I mean, I’ve, I’ve got a bit of ADHD probably. So I do a lot of different things.

Initially, when I graduated in 2008, I was offered a job in mining. Unfortunately, I turned up and I tried a uniform on and the guy said, Sorry, Zac, there’s no work here. We’ve lost the contract that’s mining.

It was a humbling experience. My rejection was the redirection to go on a journey, and I set up two AP clinics in medical centres. They’re a great company so did that for about five years. At that time, I was an ABC radio host, and had a skit on ABC.

I then worked in Surf Lifesaving as a performance coach and as a Cert IV lecturer in fitness. Then, after five years, I went into the Northern Territory in Tennant Creek, and I worked over there for about three months with a company called Body Fit. We provided access to exercise physiology in remote and rural indigenous communities. That was a great eye-opener.

And then after that, I went to Melbourne for a number of years and work down with Angelo and the team in Melbourne, in rehab, and then I had come back to Perth, to take on the role in rehab services.

MW: Wow, you’ve seen a lot of the country and by the sound of things, a lot of different sorts of people in different contexts regarding exercise.

ZJ: Yeah. And it’s the same message. And I guess the challenge is what you know, the message that you’re trying to portray, it’s about linking that to your target audience, or linking that in terms of value. So how does someone who’s recovering from kidney disease take your message, as opposed to someone who’s just been guys diagnosed with anxiety and depression?

So how do you as an AP, or as a health professional, essentially get buy-in or trust with the client? And that’s a hard skill, to be honest with you.

MW: I guess that’s where the coaching approach comes in for you.

ZJ: Definitely. Yeah. And the coaching principles. More importantly, that the client-centred approach is you really have to understand that putting yourself in the other person’s shoes, essentially, the empathetic approach. Second to that, what is it about what you’re offering do they think they need?

I mean, I’ll be honest with you, a lifestyle change is hard. And this is why it’s about the clients we have the range on the spectrum in terms of their levels of health. And it’s really important that when you coach them through each week or each session, they understand that your guiding principle of coaching is really important because of how you do your initial assessment, how you do your follow-ups, and then essentially how you educate them all comes down to that kind of format and modality that needs to really be targeted to them.

MW: I can hear that it’s very personalized, even down to the level of each individual client. That’s what you’re saying?

ZJ: Yeah, a tailored approach. So we don’t do cookie-cutter assessments. You can have two of the same people come in with the exact same diagnosis or a similar history and you need to treat them differently. The approach of, well, for example, the One-Stop approach doesn’t work, especially in coaching and health and wellness, the individuality.

So it’s really important that you understand, this is essentially going through the need to understand the biomedical markers of the person, you could ask them the physiology, and you have to understand the drive and direction in their psychology behind their motivation and their habits. You have to break this down, because what your intervention and what you’re trying to provide a solution won’t necessarily hit the mark if you can address those factors.

MW: It sounds like you have to be across a lot of stuff, generally. And then as well, on top of that the individual needs of the person or being able to identify those and be client-centred at the same time.

ZJ: Yeah, it’s difficult. And I’ve been doing it for 14 years, and I probably am still learning a lot, it probably took me at least a number of years to actually understand how to relate, also understand how to say what, when, and also how to formulate a plan to best suit my client. And this is life experience, number one. Number two, it’s understanding your trade, knowing what you can offer and also really having a thirst or a passion to continue to keep learning.

MW: It’s so important. Absolutely. I wonder if we could talk a bit about mental health because really, in this spotlight at the moment, there’s obviously a link between exercise and mental health. But I’m not sure that a lot of people really understand that link very well. So could you talk to us a little bit about that?

ZJ: Well, I mean, the link, over let’s put it this way, it’s definitely gotten a lot better in terms of the awareness, I think we have to be mindful with exercise and mental health, that there’s a component that they actually go hand in hand. But remember physical health, mental health, what comes first.

I think the main thing is understanding that from a, I guess from a medical model, so for example, in the GP, it’s about providing the lifestyle change. And then from a health coaching, and from a wellness perspective, you’re not just focusing on one part.

So the link between exercise and mental health is actually quite been studied a lot in the last probably three to four years, the rates of depression, anxiety, in particular, schizophrenia, and bipolar.

Also, there’s a lot of evidence in relation to exercise and how it modulates the brain improves, obviously, the feel-good hormone reduces cortisol, which essentially over time, what it does, it gives it a more locus of control, or competence to the client, about what they can and can’t do.

I’ll talk to you from a purely physiological point of view from the way the body responds. It improves oxygen. That’s the first point of Go.

So as we improve oxygen, when hemoglobin, obviously, blood flows for the body, that increases natural feel-good hormones, you need to do that in certain way over time to get a benefit. And the first thing I look at with mental health is called dose-response.

For example, you go walking for 10 minutes, get enough response for your body and change. It’s no different than medication now, where you’ve been diagnosed with depression, and you have 25 milligrams of sertraline or Zoloft. Does that do anything for the body? So it’s this it’s no different.

The second thing is looking at what is it about physical health that when you’re faced with a mental health condition or concern, why does that always go on the back burner? What is it about exercise and movement and eating? Well, so why does that always go to the bottom? And this is the crux of understanding that we need to break the relationship down so people can see the value.

Liking what you read so far? Listen to the whole interview by clicking the links above.

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E#163 Early Warning Signs of Mental Health Decline

This episode is about early warning signs of mental health decline

October is mental health month, and I am in the thick of Mental Health First Aid training. If you haven’t heard of this, it’s a fabulous course that equips you with some basic skills to more easily identify and directly help people who are struggling with mental health.

In celebration of this important month, I decided to share some of the common early warning signs of mental health decline.

A Few Facts

Let’s start with a few basic facts.

Mental health challenges affect your brain, your body and your behaviour. 

In this episode, I’ll talk about 
* A few facts about mental health
* What are the signs of mental health decline?

Chronic stress is a precursor to mental health conditions. It can affect your brain, shrinking the hippocampus, and subsequently decreasing your memory, mood and learning ability.

The early warning signs and symptoms of chronic stress and subsequent mental health decline may be subtle and highly individualised. 

They may not be detected or reported until a crisis state is reached, and in that sense, it can be difficult to identify people who are at risk (1) .

Physical and Physiological Signs of Stress and Mental Health Decline

  • Tiring more easily 
  • Being tired all the time
  • Feeling sick and run down
  • Headaches
  • Persistent/resistant muscle aches and pains
  • Increased or decreased reaction times
  • Changes to sleeping patterns
  • Weight loss or gain
  • Dishevelled appearance
  • Gastro-intestinal issues.

    Behavioural Signs

    Behaviours associated with mental health concerns include:

    • Not getting things done
    • Unusual emotional responses
    • Inappropriate complaints about lack of management support
    • Inappropriate focus on fair treatment issues
    • Inappropriate complaints about not coping with workload
    • Withdrawing from colleagues
    • Reduced participation in work activities
    • Increased consumption of caffeine, alcohol, cigarettes and/or sedatives
    • Inability to concentrate
    • Indecisiveness
    • Difficulty with memory
    • Loss of confidence
    • Unplanned absences
    • Conflict with others
    • Inappropriate use of grievance procedures
    • Increased errors and/or accidents.

    Many of these are ‘invisible’, may be easily mistaken for other conditions, or could be interpreted as non-significant, single events. It is only in a face-to-face (or virtual) interview with a mental health professional, who looks at a cluster of symptoms, that mental health concerns may be assessed and properly diagnosed.

    Outside of a clinical setting, or when workers are remote, it is difficult for peers, managers, clients (or for the individual themselves) to identify mental health risks.

    The stigma around reporting mental health issues is part of the issue, and this is indicated by the underuse of employee assistance programs (EAPs). 

    We know that 20% of people of working age will experience a mental health concern in any given year, yet typically only 5% of employees (across all sectors) access EAPs for mental health concerns[4],[5].

    For these reasons, mental health diagnosis is often reactive and comes too late, when things are at a crisis point.

    Filling the Gaps

    It can be tricky to know what to do when someone you know or love has these sorts of signs or symptoms.

    The best thing you can do is let them know tactfully, and directly, that you have noticed a change in their behaviour, and to ask how they are feeling.

    Better still, enrol for the Mental Health First Aid course. It’ll equip you with skills to better deal with your clients, your friends, family or coworkers.

    Summary

    Mental health can decline secretly and silently, affecting your brain, your body and your behaviour. Chronic stress is a precursor to mental health conditions. 

    The journey from not coping with stress to mental health decline can be subtle and highly individualised, and hard to see until it’s too late. 

    Today, I  described some of those signs and symptoms, and talked about mental health first aid, a course that can equip you with the skills to identify mental health concerns early on and help people in need to take charge and get back on track more easily.

    [1] https://returntowork.workplace-mentalhealth.net.au/

    [2] https://mhfa.com.au/

    [3] Robert M. Sapolsky. Why Zebras Don’t Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 3nd Rev Kindle, 2004. W. H. Freeman ASIN B0037NX018

    [4] https://www.pwc.com.au/about-us/insights/non-executive-directors/mental-health.html

    [5] https://www.businessfirstmagazine.com.au/finding-health-and-wellbeing-in-the-workplace/16285/

    [6] https://www.ihealthcareanalyst.com/government-initiatives-public-awareness-propel-preventive-health-care-technologies-services-market/

    Ready to get clarity on your pathway to success?

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    E#162 The Link Between Stress and Mental Health Issues

    This episode is about the link between stress and mental health issues

    Mental illness is a significant global issue. If we want to take a preventative approach, we need to understand the factors that lead to mental health issues. 

    In any one year, 1 in 5 Australians is affected by diagnosed and undiagnosed mental health issues.

    Mental health is a global issue, having the third highest disease burden of all diseases in Australia and globally. The World Health Organisation (WHO) predicts that depression (in particular) will be the leading health concern in both developed and developing nations by 2030[1].

    In this episode, I’ll talk about 
    * What causes mental health issues?
    * How does stress affect mental health?
    * What we can do about mental health and stress

    We know that mental health issues affect a person’s thinking, emotional state and behaviour and disrupts their ability to work, carry out daily living activities and engage in healthy relationships. We also know that early, effective prevention or intervention programs maintain good mental health[2].

    In that sense, if we can understand the causes and etiology of mental health issues, we are better placed to reduce and manage them better.

    What Causes Mental Health Issues?

    If we are to intervene early and effectively to prevent mental health issues, where do we start?

    A logical place is the link between stress and mental health. There is overwhelming evidence that stress is a precursor to mental health issues and is tightly linked to mental health decline. Stress is also strongly related to depression[3].

    Since 15 – 45% of mental health issues are attributable to workplace conditions, understanding the workplace risk factors seems to be a logical next step[4].

    How Does Stress Affect Mental Health?

    One model of stress and ageing/disease suggests that an individual’s perception of stress and prolonged exposure to stress can change the brain, body and behaviour, all of which perpetuate a vicious cycle of excessive response, damage and poor recovery3.

    In the brain, an enlarged amygdala and diminished hippocampus are related to memory loss, reduced learning ability, and depression. The longer a person is highly or chronically stressed or depressed, the smaller their hippocampus gets.[5]

    In the body, elevated cortisol levels and a chronically active fight or flight response can cause symptoms such as elevated resting heart rate or blood pressure.

    A chronically stressed person may change their behaviour to help them cope or adapt[6]. Behaviour changes may include decreased exercise and sleep, increased smoking, changes to diet and reduced adherence to medication, all of which contribute to mental and physical health decline.

    In other words, an employee who faces stressors such as constant overwork, prolonged screen time, sedentary work behaviours, feeling pressure to work or respond to emails outside working hours, discrimination, bullying or harassment, constantly facing disgruntled customers or workers, or long/irregular working hours, is at risk of chronic stress, and both physical and mental health issues[7].

    The initial signs of mental health decline in the workforce may be subtle and therefore hard to detect at first, but over time will become more obvious in terms of health metrics and behaviour change.

    Workplace Impacts

    Chronic stress and mental health concerns in the workplace result in increased absenteeism, reduced contribution and participation, reduced productivity, reduced cohesiveness and cooperation and high staff turnover.

    There are concomitant increases in the cost of health services, insurance and supplementary employment benefits to the tune of $17.4bn per annum in Australia4.

    What We Can Do

    As a starting point, the hierarchy of control is a useful framework to identify and reduce stressors in the workplace, to reduce the risk and development of mental health issues.

    If workplaces can eliminate, substitute, or reduce exposure to stress and mental health hazards, provide protection and treat the negative impacts, then we may start to see mentally healthier, happier workplaces.

    But let’s go one step further.

    We all know that prevention is better than cure. From a preventive standpoint, workplace programs and initiatives that are proven to build employee resilience and improve individual stress responses will create a workforce where employees cope well, bounce back better, are happier and more productive in their roles.

    Summary

    Mental health issues are a global concern, and they have a significant impact on both quality of life and workplace productivity.

    An individual’s perception of stress and prolonged exposure to stress are key factors in the development of mental health issues, via changes in the brain, body and behaviour.

    We know that workplace conditions strongly linked to both chronic stress and the development of mental health issues. This provides us with a golden opportunity to get on the front foot by better-managing existing risks and by taking preventive action to improve resilience and create healthier, happier workplaces.

    [1] https://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf?ua

    [2] https://mhfa.com.au/

    [3] Epel, S. et al., (2018). “More than a feeling: A unified view of stress measurement for population science,” Front Neuroendocrinol, vol. 49,   pp. 146-169, Apr 2018, doi: 10.1016/j.yfrne.2018.03.001.

    [4] Carter, L and Dr Stanford, J (2021). Investing in Better Mental Health in Australian Workplaces. The Australia Institute, Canberra, ACT.

    [5] Doidge, N. (2007). The Brain that Changes Itself. Scribe Publications, Melbourne, Australia.

    [6] Cohen S, Janicki-Deverts D, Miller GE (2007). Psychological Stress and Disease. JAMA. 2007;298(14):1685–1687. doi:10.1001/jama.298.14.1685

    [7] Johnson, a. et. al (2020) A review and agenda for examining how technology-driven changes at work will impact workplace mental health and employee wellbeing. Australian Journal of Management

    2020, Vol. 45(3) 402–424

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    Episode 108: AmIOK?

    This episode is about taking care of your own mental well-being. 

     I want to start by talking about the RU OK campaign in Australia and then to talk about the need to manage our own mental well-being as well.

    RUOK?

    R U OK? is an organisation whose vision is a world where we’re all connected and are protected from suicide.

    Their mission is to inspire and empower everyone to meaningfully connect with people around them and support anyone struggling with life.

    Their goals are to: 

    1. Boost our confidence to meaningfully connect and ask about life’s ups and downs
    2. Nurture our sense of responsibility to regularly connect and support others
    3. Strengthen our sense of belonging because we know people are there for us
    4. Be relevant, strong and dynamic

    I love that the RU okay campaign exists. It gives us all an opportunity to think about the people around us and consider how we can offer support. 

    It means that we are proactively reaching out to check in with people and to help them to speak up about what’s going on for them so they can get help.

    I had a conversation with somebody one-day who I knew was severely depressed and going through a major incident and I had reached out to say are you okay. 

    It was a difficult conversation because I hadn’t yet trained as a coach and this person was very upset but I was concerned about their mental well-being so I did the best that I could with the skills that I had at the time. 

    Months later that person phoned me and said they were considering suicide the day I had called – they were getting ready to do it – and the conversation we had stopped them from taking action and caused them to reach out for help. 

    Truly, I was taken aback that the conversation had had such a powerful impact on that person and it made me thankful that I’ve been able to help but also concerned about my skills and education and knowledge in this area.

    So where and how do you start getting these skills?

    What if you’re not a coach or working in a support capacity but want some basic understanding and skills?

    Mental Health First Aid

    It’s worth mentioning the mental first aid course.

    Several organisations deliver this course: Mental Health First Aid Australia says that: 

    Each year 1 in 5 Australians will experience a mental illness. Many people are not knowledgeable or confident to offer assistance. Physical first aid is accepted and widespread in our community, however most do not cover mental health problems. Mental Health First Aid (MHFA) teaches people the skills to help someone who they’re concerned about.

    What About Me?

    All of this got me thinking recently about the fact that there are many campaigns that are outward directed – helping us to check in with the other people about their own mental health and well-being.

    But just as important is the ability to be self-aware and identify our own mental health challenges.

    As a coach, I know that one of the main reasons people hire coaches is simply that they lack self-awareness of how they are thinking and operating in the world, and what their habits are.

    People are either too busy to notice themselves and reflect on their behaviour, needs and wants, OR, they notice an issue coming up for themselves but say ‘she’ll be right, I’ll just push through.’

    The old ‘she’ll be right attitude’ is a mask that many Australians have been wearing for a long time.

    In either case, most people simply don’t know HOW to check in with themselves or to ask for help.

    They say, I’m okay, don’t worry about me, everything is fine. I don’t need any help, I’ll put on my big girl pants or I’ll pull up my boots and I’ll just get on with it. 

    I can totally see how we came to be that way. That attitude comes from the hands-on, roll-up-your-sleeves, hard-working people who founded modern society in our nation.

    Think about it – once upon a time, not that long ago, we were a nation of pioneers in a new country who travelled long distances, lived off the land and managed many hardships to establish towns and cities. We were the kind of people that pitched in and did things and got on with things and to build a great nation.

    But these days, there is a changing of the guard.

    We have the rise of Gen Y (with more of a values focus, in my opinion) as dominant players in the workforce and leadership positions. 

    We have an increase in multiculturalism in our society, and a need to consider people with different cultures, ethics and values.

    And we are giving more attention to well-being, health and mindfulness. 

    With all of this going on, we are starting to realise that the old ‘she’ll be right attitude’ is a mask that many Australians have been wearing for a long time.

    The old stigma around mental health issues, not wanting to show any weakness or to be judged, has to come off.

    We have to learn how to ask for help.

    But first of all, we must be self-aware enough, to know when we need to get that help.

    AmIok – a new paradigm 

    I propose a concept that sits alongside RUOK, to acknowledge that it’s just as important to check in with yourself rather than to ignore the warning signs and push through. 

    I want to ask you to think about a new paradigm. 

    The AmIOK paradigm. 

    Certainly check in with the others and ask are you okay, but at the same time give yourself the attention to – how am I travelling? 

    Am I ok? 

    And if not, what do I need, how am I feeling, what’s my capacity, and what do I need to do differently? 

    I had this experience myself recently. 

    I noticed a few things were becoming difficult for me. 

    I was starting to avoid certain situations and certain tasks that I didn’t like. 

    Normally I can do tasks that I don’t like or don’t enjoy, but when I’m stressed, under a lot of pressure then I go into avoidance of those basic tasks. And to me that is a sign that I need to step back and check in with myself. 

    Other signs that I need a break or to get help are that my cooking is boring, I’m not sleeping well, and I feel frustrated, and starting to look for more coffee.

    Basically, I lose my enthusiasm and creativity. 

    When those things start to ebb, I know it’s time to take a break or to get help.

    Summary

    RUOK is a wonderful initiative that helps us to lower the risk and rate of suicide, by reaching out to others.

    It’s important to check in with yourself rather than to ignore the warning signs and push through. 

    Mental Health First Aid is a great training course to gain basic skills.

    I propose a new paradigm – AmIOK? – as a means of learning to give our own needs more attention and to get help sooner rather than later.

    Ready to pay more attention to your own needs?

    It’s OK to be not OK, but it doesn’t always have to be like that. If you need help to feel more in charge of your life, I encourage you to check out the Habitology membership.

    Learn more here: