206: Finding Your Steady in Uncertain Times

Scot: Whether it's a personal struggle, maybe unemployment, maybe a tragedy in your life, maybe a larger situation outside of your control, it seems like unprecedented times is a new normal. You know what I'm saying, right? We're kind of on our fourth once-in-a-lifetime week in a row. Times of uncertainty can be really stressful, and today we're going to talk about how to deal with stress in times of uncertainty.

Mitch, do you have anything you'd like to share with the group about being overwhelmed by uncertainty? One of the questions I want to ask first when we get into this is, is stress from uncertainty different than other kinds of stress fundamentally? Because I think it might be, and I'll explain why if I have to. But are you feeling stressed by uncertainty, and how are you handling that? What are you doing?

Mitch: Oh, it's been a while since I've had a real uncertain moment. I mean, I read the news and doom scroll still today, and it still stresses me out, but the really uncertain times in my life that have really impacted me are times like . . .

I was without a steady job for two years after college, right? And during that time period, every single day was trying to earn a little bit so you could feed yourself for the week or whatever. And during that particular time, yeah, it really wore on me. At that time, I don't think I handled it very well.

Scot: It's not something we're normally taught, right? It's a skill and it's a tool set that we have to have as guys to be able to deal with that. Otherwise, I think we can find ourselves dealing with it, like you did, in not such healthy ways. What did those ways look like? Was it a lot of taquitos or . . .

Mitch: It was a lot of just real quick rash behaviors. I signed up for a job that I probably shouldn't have, and it got me really close to a cult, but that's a different story on a different situation. I've never been in a sketchier situation. But between that and unhealthy health behaviors, etc., yeah, it was not a great way to handle it.

Scot: Yeah. Eating, drinking things that probably aren't the best for us and in quantities that are definitely not the best for us.

Dr. Smith, how about you? Stress from uncertainty, is that something you catch yourself in, and what are your sources and do you have ways to deal with that?

Dr. Smith: I mean, I think there's always uncertainty in all of our lives that we deal with. I tend to try to stay positive on a lot of things, is the one thing that I've kind of managed to try to do in my life that's been mostly successful for me. But I think I've tried to figure out other things and sometimes I've been successful and sometimes I haven't.

Scot: I'm actually in a very uncertain time in my life. We have some family health issues that are open-ended questions right now. And that is extremely stressful because you just don't know where that's going to end. I don't know what I need to do right now. Do I need to take some time off? Do I need to clear my calendar? What do I need to do? And then on top of that, all the other stress that goes along with it. So that's something I've been experiencing.

I think we're going to get into more strategies a little bit later. I find sometimes, though, trying to get as much information I can about the situation. For me right now, with these health issues, it's the way I tend to alleviate stress. I think stress by the unknown, if you start to make stuff known, uncertainty/unknown, then it helps me feel a little bit better.

But anyway, let's get into this here. So it's "Who Cares About Men's Health," information, inspiration, a different interpretation of men's health. I bring the BS. My name is Scot. The MD to my BS is Dr. John Smith, who's just taking it all as positively as he can, and I love it.

Dr. Smith: Trying every day.

Scot: With me is health convert, Producer Mitch.

Mitch: Hey, there.

Scot: And our guest today is Dr. Jason Hunziker. He's the division chief adult psychiatry medical director at Huntsman Mental Health Institute.

So, first of all, is my theory that stress caused by uncertainty is fundamentally different than other stress, or am I just making stuff up?

Dr. Hunziker: No, you're not making anything up there. I would agree that when things are unpredictable, our brains do not care for that very much and it flips into survival mode. And when it does that, that's when things start to go haywire.

Scot: Right. So the other kinds of stress we think about are stress of meeting deadlines at work or having a lot of work to do. That is fundamentally a different kind of stress as the stress of unknown. We respond to it physically and mentally differently is what you're saying.

Dr. Hunziker: Exactly. When we have a stress that has a known cause and an end point, our bodies handle that much better. In fact, those kinds of stressors are really good for us because it helps sharpen our skills, it helps our brains get going, and it helps us build resilience for stress that comes later down the road. And because it's known, it has that point that it's going to end. And so we can put that time in and that effort in to make it so.

Mitch: I mean, even hearing that, "Hey, I can tough it out," I'm wondering if men have any specific extra struggles. Anecdotally, I always try to control situations. I always like to feel useful and like I'm accomplishing something, etc. And so whenever I'm in an uncertain situation and I literally do not know what to do or it's a situation where I cannot literally do anything, there's this extra something.

And I just wonder, is there something you think about when it comes to how men are wired in this country, in this culture, etc., that might exacerbate things even further?

Dr. Hunziker: Definitely. I mean, I know when I grew up long, long, long time ago, men just couldn't show any of that emotion. We were told that we just toughed it out. And it didn't matter what you were doing. You're on the football field? Sorry, tough it out. There was no time to feel anxious. There was no time to feel down.

And so we heard that we had to be strong and, unfortunately, we're not always in control of everything. We can't control the chaos that happens in our lives. And so as we try to just be strong and ignore it, that's when we set ourselves up for all of these bad coping strategies that don't allow for us to deal with what's really happening.

Scot: How much of it is being strong and ignoring it or not even realizing what's happening to us?

Dr. Hunziker: Yeah, that's a great point. I do think that because we . . . Again, men are told, "Hey, there is a nail over there. Take this hammer and go hit it." But when we feel like, "Hey, there's something we should be building here, but there's no building material, what am I supposed to do?" then we start to feel these weird things that we don't normally feel. Our jaws are tight, our shoulders are just clenched up around our ears, and our stomach is flipping around, and we're like, "What do we do with this? I don't even know what this is."

And so then we start stupid stuff, right? We start to figure out ways that we isolate, or we start drinking a lot, or we start snapping at all these people around us. Worse, we stop doing those things that we really like to do in the first place, and that just makes things even worse.

Scot: I've got to say I think I went a lot of my life experiencing stress and I would always say, "Oh, I don't experience stress. It's fine." But it's been just recently that I've discovered and I've become more in touch, and I'm not even sure how, probably through this podcast, probably through these conversations, where I've paused and I've gone, "Wait a minute. This feeling in my gut right now and this anxiousness that I have and whatever other things I'm feeling, I think this is stress."

Is that common that guys don't know and then eventually they figure it out? Or what's your experience with men when it comes to that? And how did I finally get there, do you think? How could other guys get there?

Dr. Hunziker: I think that's more common than we like to hear about. I think that we don't get it often. And then we don't want to talk about it because we think it's a sign of weakness that somehow I can't manage this thing that everybody else seems to be able to manage but me. I'm not going to say that to anybody, and so I never really get the opportunity to understand what it is because I'm afraid to bring it up.

Mitch: Speaking of bad behaviors, that was one of the things that I found myself in that uncertain situation. When I was prolonged, not sure where food was going to come from, etc., it was straight to isolation. But I didn't think I was isolating. I was solving the problem. That's why I'm not going to go see anyone. I need to hunker down. I've got to put my head down onto the . . . I've got to put my nose to the grind wheel and make this work, right?

And so it didn't even dawn on me that I was engaging in some really not so great behaviors, because I was solving it. I was taking control.

Dr. Hunziker: And I think control is the big thing, right? We talked about it at the beginning that when we are out of control, that feels terrible. There is nothing that feels worse to me than when I know I don't control what's going on around me.

The alarm bells are going off. Your amygdala is just shooting out all kinds of chemicals everywhere, and it's telling the whole system, "You're in trouble." And instead of stopping and looking and saying "What's really going on?" we do all these other things that actually add to the trouble.

We isolate ourselves, we pull back from people, we stop exercising, we eat terrible, we don't sleep. And then things keep winding up because we're thinking we have the solution, but we really don't have the solution, and it just gets worse and worse until it just explodes.

Scot: In your clinic, when you deal with patients, are you seeing a lot of stress from uncertainty because of the unprecedented times we're in?

Dr. Hunziker: Definitely. And I actually just do inpatient work for the most part, but I will say that a large portion of people that come in have just these terrible things going on in their life in addition to the world itself.

They have the unemployment, they have the "where's the food coming from?" they have kids at home, and they're three months behind on their rent, and they just lost their job. And then you add all of these other services that are getting taken away and all of this stuff, and they don't know what to do. It causes them to crumble to the point that they need to come in and see me.

Scot: Yeah. What do you do?

Dr. Smith: I was going to say what's the first step of starting to address this?

Scot: Yeah. I mean, it sounds pretty terrible.

Dr. Hunziker: And anxiety, it is terrible when it happens all of the time.

Scot: All right. Hold up. You used anxiety. So is stress from uncertainty also anxiety? Are these the same things?

Dr. Hunziker: Yes. Thank you. This is what it leads to, right? Our stress can create a lot of different things for people. And sometimes, like I said earlier, it's good stress. We have this good stress that helps us build resilience and feel better.

Scot: And perform better.

Dr. Hunziker: Exactly.

Scot: And be more competitive and really shoot for those goals.

Dr. Hunziker: Exactly.

Scot: Stress from the unknown leads to anxiety.

Dr. Hunziker: It can lead to anxiety and depression and a whole host of other mental health concerns if we don't take care of it.

Scot: What are some of those other concerns? Name those too, because I think if we can name those, that would be helpful.

Dr. Hunziker: Yeah. The different anxieties . . . So generalized anxiety is when you're just literally worried about everything. Everything causes you distress from you driving to work, to where the money is coming from, if your family members are going to be okay. I mean, every little thing sets you off.

Scot: Or, "What should I make for dinner tonight?" causes you stress.

Dr. Hunziker: Exactly.

Scot: Things you wouldn't expect to cause you stress.

Dr. Hunziker: Exactly. You just can't think about anything because your mind is so preoccupied with everything that nothing can really get done. And so that would be the generalized anxiety.

And then people have panic disorder where they're going along fine, and then all of a sudden, they go running screaming out of the building. They feel like the world is coming down on them, and for all intents and purposes, they're having a heart attack. Their heart rate is up, they have terrible chest pain, they can't breathe, they have impending doom feelings, crying, and tremulous. It is a terrible experience for people who have this. And then it slowly fades over a period of 10 to 15, 20 minutes, but the anxiety can linger for a few hours.

It's unpredictable. We have no idea when it comes, why it comes. I mean, sometimes we have triggers. Other times, it just happens.

Dr. Smith: I was just going to ask, what are some of the early warning signs? Because it sounds like you're the guy who sees people when they've hit that breaking point and things have kind of snapped. I'm thinking what can we help our listeners, what can we help folks with, and even help ourselves with of what are those first things that we might want to start to notice in our lives or in ourselves that might make me stop and do a little check-in with myself and go, "What's going on here?"

Dr. Hunziker: Again, this is what it's all about, right? It's about us, first of all, figuring out this is what it is and being okay with saying, "Hey, we don't have the answer to everything." And I know that's hard for men to think about, because I know personally I have the answer for everything.

Scot: Well, that's why you're on the show.

Dr. Hunziker: Exactly.

Scot: So you're good. You're fulfilling your purpose.

Dr. Hunziker: And I usually tell people that nobody's perfect except me, so the rest of you need to do this.

But no, I think if we can identify, first, "This is what we're experiencing," and then we can look at the things that have changed in our life. We start to notice our sleep is terrible or we're waking up at 2:00 in the morning and we can't get back to bed. Or that family is going out on things that we always did, but now we're not doing that because it seems like too much energy or too much work to do.

We're forgetting things at work that typically would just come to us, and we just can't remember stuff. Our body feels terrible, which is usually the first thing men will feel, is that their body starts to feel weird. Their back hurts more, their shoulders hurt more, they have this weird stomach pain, and maybe they have changes in their digestion. Things seem to just always upset their body first, and then it progresses to this more emotional piece.

Scot: Right. I've heard some of the early warning signs can be categorized into body cues, behavior cues, and then thought patterns. So I think you're talking about a lot of body cues, right?

Dr. Hunziker: Yeah.

Scot: That clenching the jaw. By the way, how many times, guys, have you caught yourself like, "Wait, what am I doing? Why am I clinching my jaw right now, or why do I have my shoulders hunched?" So I think, Jason, you're saying those could be some of the preliminary cues that some things are going down.

Dr. Hunziker: That's right.

Scot: What are some of the behavioral cues? I've noticed for me, I think when I start to shut down and I'm experiencing stress, I scroll a lot. I think it's a form of escape, maybe.

Dr. Hunziker: I agree. I think that some of the behavior stuff, your screen time does change, and you start paying attention to . . . You'll sit on these stupid websites where you're reading this crap all the time over and over and over. It's like, "How many times do you need to hear this?" but you do it anyway.

Scot: It's the equivalent of junk food. It's equivalent of eating junk food when you're stressed, except it's mental and emotional junk food, I feel like.

Dr. Hunziker: Exactly. Or other people will get on Instagram or Facebook, and they'll see what other people are doing, and they're like, "Why am I not doing that? How come they're doing this and I'm stuck here doing . . ." And they get stuck in this cycle of comparing their situation or their life to what they're seeing, which, of course, is not reality.

That's what stress is. It's not a rational thing. It's a thing that happens when we don't pay attention.

And again, I want to be really clear that all stress is not bad stress, but the stress we're talking about that leads to these other disorders, that's what we're talking about when we say it's not a great thing for us.

Scot: Hey, Mitch, John, are there some behavior cues that you have that indicate that maybe you're starting to go down the road of being stressed?

Dr. Smith: I was actually going to chime in and say that I become irritable. I'm a little bit shorter with something that might not have bothered me much when I was on a different day, like with my kids. Something just kind of, "Ugh, that grates on me," or some of those things.

When I'm under stress or things like that, I find myself being a little bit more . . . not necessarily short-fused, but just definitely more irritable and short with my patience or my limit of BS for the day.

Scot: Yeah. How about you, Mitch? Any behavioral cues for you?

Mitch: So my old coping strategies were caffeine and cigarettes.

Scot: That's a classic. It's a tried and true.

Mitch: Classic. Love it. Absolutely. And it's bad enough . . . if you go listen to our "7 Domains" episode, I was on the 7 Domains of Caffeine. I had an overdose of caffeine in my life because I just kept chugging one super energy drink and a NoDoz and a 5-hour Energy drink, etc. It was a badge of honor back then, being 20 and dumb.

Scot: One of my behavioral cues, I think, is procrastination. I put things off. Or I just don't even have the energy to do it, which I'd imagine, Jason, that's a little bit more of an advanced stage.

What about thought patterns? What are some thought patterns you guys notice if you feel like maybe stress is starting to show up?

Mitch: I get cravings to go smoke cigarettes and drink more caffeine.

Scot: Cigarettes and caffeine. That's your thought pattern, huh?

Mitch: That's the thing. Yeah.

Scot: All right. How about you, John? Do you have any thought patterns that you fall into?

Dr. Smith: I tend to just become more negative. I talk a lot about trying to stay positive, and I just notice more negativity. I just find myself kind of . . . not wallowing, but finding myself just dwelling a little bit more on things that I normally wouldn't that are on the negative side of things.

Scot: Hey, Jason, how about you? Or what are some of the other things that we haven't mentioned when it comes to thought patterns that you see in patients?

Dr. Hunziker: Well, I was just going to say, for me, I get to some points where I start doubting what I'm really doing. So I'll be like, "Is this what I should be doing?" And it gets tough, because you know you can do this stuff, but there's that doubt that comes up when you're feeling too much stress that maybe you're not making the right decision, or maybe this is the wrong thing, or you shouldn't have said it that way.

That's when I know, "Hey, I've got to step back and ground myself again so that I can get back in there and then try to pay attention to what else is going on in my life." And if there are things I can change, I want to do that.

Scot: Hey, Mitch, one time you said that you catastrophize a lot. Is that . . .

Mitch: Oh, yeah.

Scot: Yeah. So that's another thought pattern, I imagine, isn't it, Jason . . .

Dr. Hunziker: Definitely.

Scot: . . . that people can fall into? Or this all-or-nothing kind of thinking.

Dr. Hunziker: The black and white, yeah.

Scot: So a lot of these things, it seems to me that if we're noticing these things, whether they're body, behavioral, or thought patterns, instead of just going, "Well, I guess I'm just irritable," and thinking it's a character flaw, maybe it's a good idea to reframe that as a signal.

Like, "I'm scrolling Instagram a lot. Oh, I guess I just don't have the will to do real meaningful things." Maybe instead I should be like, "I'm scrolling Instagram a lot. Maybe there's a little stress. I need to do a little bit more investigation."

Is that something you coach guys to do, or what do you coach guys to do once they recognize these things?

Dr. Hunziker: Definitely. I think, again, the biggest thing that we can do is recognize that there's a problem. And then once we recognize the problem, we want to make sure that we're open to the possibilities that we can make a change in this problem that we're seeing.

Sometimes the things that we ask people to do sound a little hokey or a little magical or a little too touchy-feely for some people. But there are a lot of things that we can do just sitting here by ourselves. We don't need other people to help with some of this stuff when we recognize that it's happening.

Scot: All right. Is ignoring what's going on one of the things?

Dr. Hunziker: Well, a lot of us are really good at that. I think we ignore, we ignore, we ignore until we can't anymore.

Scot: Oh. All right. Not so good, it sounds like.

Dr. Hunziker: Not the best plan.

Scot: All right. Well, I was hopeful.

Dr. Smith: The sibling of procrastination.

Scot: Yes, ignoring You're right.

Dr. Hunziker: Exactly.

Scot: All right. So we've got some early warning signs. We've talked a little bit about what can happen if we ignore those early warning signs, where we can end up at. Again, those are even signs that, "Oh, maybe we should do something." What are some practical tools that we can apply when we're dealing with stress from uncertainty?

Dr. Hunziker: One of the things that I think is the easiest for people to do is to build these systems around their values. We all have those things that are priorities that help us decide what kind of person we want to be, and we can use that even in times when life is chaotic.

You can think of a value as somewhat like a compass. I mean, it gives us some direction. It doesn't tell us, "Oh, turn here, or turn there," or, "Do that," but it helps us point us in the right direction. And we can make those small choices that align with those values.

So if you're a family guy and you're really stressed, instead of isolating from family, you should show up. Let's do something with the family. If you're an exercise guy, if part of your values is being physically fit, you should do that. If you're a social person and now you're not, you should be calling your friends instead of avoiding them. If you're a truth teller and you believe in your word is your bond, then you need to follow that.

Those things will help decrease the stress that you're experiencing and help you feel more in control, because instead of reacting to things and living your life reacting, you're actually living with intention and purpose because you're working towards your values and your goals in your life.

Scot: Hey, we're going to play a little game, guys. We're going to talk about tools you use to manage. So Mitch, I want you to give me a practical tool that you use to manage stress. I mean, it may or may not be good, but hopefully it's one you think is good or appropriate. So what's something you do?

Mitch: I'm a former journalist, and so my knee-jerk response when something outside of myself is going out of control is I go to find more information. But it's really hard to find good information these days, right?

Scot: Oh, that is stressful.

Mitch: So my knee-jerk is doom scroll. Look as much as you possibly can into the situation, and some clarity will come. I mean, I've been trying to look for clarity in the news for like six, seven years now and haven't found it. So what I do now is I just limit that particular behavior to when it is the most manageable and useful in my life.

I try really hard to stay off of social media and certain news sites. The first hour or two of my morning, I make sure I have a breakfast. If I can get a workout or feel like I could do something, I'll try to do that in the morning. And then in the evening, too, the hour or two before bed, no news.

Honestly, nothing severe is going to . . . The immediacy of the technology, I think, that we have at our fingertips outpaces the actual newsworthiness and value it gives to us, period.

Scot: Or our brain's ability to handle it. I had a girlfriend one time . . . I'm comparing the news to a girlfriend, yes.

Mitch: Love it.

Scot: I had a girlfriend one time that had to narrate and take me in real time through everything she was feeling, going through, or whatever, and it was exhausting.

Dr. Hunziker: Yeah, that is.

Scot: It's exhausting. And that's the world we're in now, except it's the news and it's information. You're getting this fire hose all the time.

I don't do this now but when I still worked in an office, there was a newspaper and that's what I was doing. I was getting my news from a newspaper. I was trying to modulate the amount. At least here's something stable for the day. It's not constantly in flux every minute and every hour.

How about you, John? Is there a tool you use that you've found useful when you're dealing with anxiety from uncertainty?

Dr. Smith: I think the biggest thing I try to do is just set some short-term, medium-term goals to try to get me through this stressful situation. Like you say, when we have control over things. I may not have control over the situation but I can set a goal to do X, Y, or Z, and then I can follow up on that, and that gives me a little bit more comfort in the fact that I have something to achieve.

I'm a very goal-oriented person. My wife's a runner, and I've always said I don't run, but I'm like a dog and if you throw a ball, I'll go chase that ball.

Mitch: Yeah, I love that.

Dr. Smith: I'll go play basketball or soccer for five hours, right?

Scot: There's a guy that knows how he operates. I love it.

Dr. Smith: And in a similar vein, that little goal-setting for me changes my mindset of that . . . not competition but kind of that competition of, "I want to reach that goal. I want to have that little teeny bit of success no matter what it is."

For me, that's been something that I've utilized of . . . Whether it was struggling with finals in college, I would take the approach of, "I'm going to study for 40 minutes and then I get 15 minutes to myself to do whatever the hell I want to do," or little things when there's . . .

Scot: And what did you do, by the way, in that 15 minutes?

Dr. Smith: I mean, it depended. I may have just taken a nap. There were times where I would do that, or I would go to the gas station and get a drink, or I would go down to Sconecutter. Shoutout, they're all closed, but they were open 24/7. And so it'd be 2:00 in the morning, I'd be studying for finals, and there was a Sconecutter literally the block over from where I lived, and so I would go over there and I would get the scone nut with chocolate on it. That would be my 15-minute little break, and then I would have to hit studying again.

So I kind of break it down. You know the dumb football coaches that are like, "We're just going to take it one play at a time"? I mean, that's pretty much what I've done in stressful situations to try to help kind of lead me along.

I think that's one of the coping mechanisms I personally use. And it's some of those similar mind tricks that you hear coaches and things say, "One game at a time. One blah, blah, blah." And really, for me, I do set these shorter and medium-term goals of, "I'm going to get to Thursday, because Thursday, 90% of this stuff is over," or 50% is over. I don't know. That's what I've done and that's what I've found that's helped me to be successful.

Scot: I love one step at a time, Jason, because I think one of the things that happens is we start to do these what-if scenarios if we try to get too far ahead.

Dr. Hunziker: No, I agree. And I like that idea of that same ritual, same time, same way because your brain is going to interpret that as, "Well, then it must be safe."

Scot: Oh, stability.

Dr. Hunziker: "If we're doing it this way, then it must be safe." And then it starts to decrease the intensity of the emotion that surrounds all of this.

Scot: Right. Those coping mechanisms that we had, were those pretty good tools or are we . . .

Dr. Hunziker: No, that's great.

Scot: Okay. We're not on a fast track to disaster?

Dr. Hunziker: No. I'll tell you, my coping mechanism is a shower every day.

Scot: Yes! I know.

Dr. Hunziker: I get up in the morning . . . I will tell you some of my best thoughts come when I'm sitting in the shower. There's nobody around, there's no noise, I keep the lights low. You just sit in there and you let that water run over you, and somehow it releases all the tension and gets you ready for the day. You just take those moments that you can get of that quiet so you can just quiet everything in your mind and refocus.

Scot: Yeah, I like that a lot. Something else I like to do is I like to allow myself a certain amount of time to just really all out worry about it. I'll sit down in front of a notebook or a computer and I'll just pry the sob story, man. I'll just talk about all the things I'm feeling.

And a lot of times, just that dump makes me feel better, but it also then kind of clears things. It gives me a chance to get rid of it and then I can move on. So that's another one.

Dr. Hunziker: That's great.

Scot: Is that something that you recommend or . . .

Dr. Hunziker: Definitely, yeah. I think that there should be time that you're worrying, and you can put it all into those 15 minutes or that half hour or that hour, and then you make it that time. Then after that, it's like, "Nope. I've got these other things. My worry time was right then."

And the idea of writing it out, I think, is really powerful because if we write stuff down that we're worried about and it's on a piece of paper, we can do whatever we want with that paper. We can hold that paper, we can carry it in our pocket, we can put it on the shelf, we can burn it, we can flush it, we can tear it up. I mean, whatever you want to do, it's now gone.

Scot: Yeah. We can flip it off.

Dr. Hunziker: Exactly. You can do a lot of other things. It's a family show, so I kept it clean.

Scot: All right. I love some of these ideas and some of these things that you guys are talking about. Something that really came through to me that I guess I try to do, and sometimes not 100%, is if it's stress from uncertainty, and Jason, you alluded to this, then create a routine. Try to create moments in your life that are certain.

And I think we can go back to the Core Four to that. A consistent bedtime, a consistent wake time, trying to eat consistently throughout the day good food. We already talked about exercise. Consistent social time for a little bit of mental health. Maybe a hobby that you enjoy you consistently go do. You go to the Sconecutter and you get this thing that I've never heard of, and now that I can never have, and it sounds so great.

Dr. Smith: You missed out, man. You missed the boat. I'm just going to say right now.

Mitch: As a fellow Sconecutter lover back in my heyday, a 3:00 a.m. scone is . . . It seems crazy on paper, but . . .

Dr. Smith: If you know, you know, man. That's all there is to that. If you know, you know.

Scot: Yeah. We talked about other things like one small valued action, doing something that's important to you. So maybe you schedule that.

Are there other kind of practical tools we should talk about, or is that a pretty good list for some guys?

Dr. Hunziker: I think that's a good list. I mean, I think one I would add is just the boundary setting. I think that would be another thing to do, because as men, we do say yes a lot, and we just keep adding stuff to our plate even though we are overwhelmed. We need to be comfortable saying, "Hey, this is all I can do right now," and save that time for those other things you just mentioned so that we have time for ourselves.

Scot: Yeah. Evaluate the thing you're being asked and see, "Can this feed back into helping me get through this stress caused from uncertainty?" If it's an invite to hang out with some guys and you've got a little extra time, go do an hour, right? Because that's good if that's something that you value.

Dr. Hunziker: Right.

Scot: All right. So we should always talk about when to get help and how. So hopefully, we've given some people some skills to try to get through this stress from uncertainty. But if they're at such a point where it's just unsustainable, and somebody doesn't know what to do, what do you recommend?

Dr. Hunziker: Well, I always recommend you talk to your family, your significant other, or your friends. Bounce some stuff off of people first and see kind of what their thoughts are about things. And then you can kind of work your way up the chain from there.

Get in to see your primary care provider, and let them know. I will say our primary care providers in this community are so much more attuned to mental health and stress issues than they used to be. Everybody is asking about it, and everybody's interested, and there's warm handoffs to others that can help immediately with these problems.

And so there's no reason not to talk to your doctor about it anymore. And it's not about, "Are they going to give me a pill?" No. It's about they're there to listen to you and then help guide you on what to do next.

Scot: All right. Sounds good. And if it's really bad, are there crisis resources available? We'll talk about those a little bit, because I know you're heavily involved in that.

Dr. Hunziker: Definitely. I think if it's bad enough that they're saying, "Hey, we're at risk," we do have crisis services. We've got a crisis line for people who feel that they may be a danger. You can call 988, and it will route you right to the crisis service.

In Salt Lake County, there's a mobile crisis team that can come right to your house and do an intervention if necessary, if you're feeling overwhelmed.

We have a warm line where you can just call and talk if you're not in a severe crisis, but you're feeling like you just need somebody to talk to that might understand. You can call and talk to them. Go into any emergency room. You can also activate the crisis from any emergency room as well.

Mitch: The one thing I want to put on the site here is that I found out in a recent story that you can text 988. So as a phone-anxious millennial who's like, "Oh my god, never," you can text them. You'll be okay.

Dr. Hunziker: Yeah. And there's also the SafeUT app that you can use. It's all a text-based crisis.

Scot: I've never been in crisis, so that's something I can't understand or relate to. And if I was in crisis, would I recognize it?

Dr. Hunziker: I think that, again, this is where we count on those around us to really kind of open that perspective for us, saying, "Hey, you just don't seem like . . . This is not how you normally are. I think maybe we need to get you somewhere to talk to somebody and see what can be done about it."

I mean, I think if you fell down a mountain and your bone was poking out of your leg, you wouldn't question that you were in crisis at that moment.

Scot: You're right.

Dr. Hunziker: But I think when we can't handle things and we're snapping at everybody and we're having episodes of rage, and then we're not showering, we don't see that the same way, but that is the same crisis. That bone is sticking out. We need to go get it addressed before it gets something worse.

And I think that if we start to empower men to recognize that this is okay, this is not a sign of weakness, and in fact, this is a sign of strength to recognize that you need something, and then go ask for it. I think that that's not what we've grown up with, that's not what we were taught, but that is the reality.

Scot: So crisis. One of the hard things I have is, first of all, I never want to be a bother. I don't want to bother anybody. And two, what's the threshold? Have I crossed it? And I think it's pretty obvious if you've got a bone sticking out.

I remember when I was a kid, I was playing baseball with my dad in the backyard and I swung around. We were simulating I was stealing a base and he was going to get me, so I was going to go back to my base. And I whacked my leg into this metal clothes pole that was in the ground. I remember after I did it, I probably cried and the first thing he said is, "Oh, just walk it off." And I remember trying to walk it off and I could feel bones slipping by, right?

So in that instance, what's the difference between "walk it off" and "I know bones are slipping by and I really should talk to somebody"? How do we determine that?

I think maybe there was a clue in what you said. I'm going to extract that and let's dig deeper. I think the clue is if you're not the person you want to be or not behaving in a manner that you want to behave in. I think that's a clue. Are there other clues like that that are tangible things?

Dr. Hunziker: Yeah. I think a lot of it we have said. I agree, if you're not who you want to be and you're doing things differently than normal, or you can't tolerate the things that you always can tolerate. I think we've talked about being snappy or being more irritable or being on edge, but it's all of the time now. That's your new pattern.

You're not sleeping at all, you're not getting things done at work, at home, you're fighting more with your partners and your kids and people at work, that's it. That's time to get in.

Scot: Or this is not the life I want.

Dr. Hunziker: Exactly.

Scot: The life I'm leading right now is not the life I want. So what can we do about that?

Dr. Hunziker: And the cool thing is that we can do so much about it. That's what's so cool about it, is there are so many things that we can do to take care of this. We know it gets better because this isn't how you have always been. And so we know we can get back to that. It's really just learning some new skills. If we need to, we use a little medication, and things can get right back on track.

Scot: I love how optimistic you were just then about we know that we can help you with this. So when somebody walks in your office in the way we described, you don't go, "Oh, boy." You go, "Wow, this is awesome because I know I can help you. I have the tools."

Dr. Hunziker: Yep. And that's exactly what I say. I mean, I listen, and I understand, and I validate it because it is terrible for them right now, but they don't see what I get to see, which is all of these people get better having these terrible things happen when we do these certain things for them.

And what we do is . . . there are so many different things. We find the thing that fits best with who they are, what their values are, how they like to do things. And invariably, we find something that puts them back on track. I think it even amazes most people that all it took was them to come in and say, "Help me." And then all of a sudden, we gave them something that helped them.

Mitch: Oh, yeah. As someone who was extremely against it, someone who was initially diagnosed with a generalized anxiety disorder, someone who struggled with panic attacks, etc., I was kind of shocked. It took me a minute to find the right mental health person. I never hit full crisis, but I finally was like, "Hey, there's got to be some better way to do this."

Once I found the right guy, I was really quite surprised at how quickly there was . . . Because I did end up having a bit of medication just to take the edge off of that general anxiety disorder. And then I started to actually be able to talk through some things and figure out what my triggers were.

I mean, I'm a horror buff, and so my therapist always told me I had to be taught how to name the demon, because unless you have its name, you can't exorcise the demon, right? And so, for me, that was a big . . .

Dr. Hunziker: That worked.

Mitch: Within two, three weeks, he was like, "Hey, what's your jaw feeling like now? Let's give you a quick tool. We'll give you a medication. We don't have to be on that medication forever." And go figure. I "graduated" from my mental health specialist last year. And so four years later, I'm feeling pretty good. I've got tools, I've got abilities, and I've got a lifeline if I need it.

Dr. Hunziker: I think one of the things you said there that I really want to point out that I thought was really cool is you found the right guy. That means you didn't stop and you didn't see just one person and think, "Oh, well, this is never going to work," and didn't go back. You went and found the right guy, and that is so important.

I mean, we don't just walk in and meet people and say, "Yeah, they're going to be my lifelong friend." We don't do that. We go in, we see somebody, some people we like, some people we want to see again, and some people we never want to see again.

I think that is so important. Just because the first or the second or the third don't work out doesn't mean that the fourth guy isn't going to make the difference and change everything.

Scot: Hey, John, let's get you in this as we start to wrap this up. What are you taking away from this? Do you have any thoughts either from your own perspective or perspective of patients that you've dealt with? Now, you are a urologist, but a lot of times you will likely discuss issues of stress from uncertainty with individuals and probably deal with that, right? Some of the problems they come to you with probably bring stress from uncertainty.

Dr. Smith: Oh, absolutely. I mean, some of the things that I deal with men with are some of the most stressful things for them. They come in with issues with sexual performance, things like that. Those are very stressful things that a lot of guys take pride in being macho or whatever. And those things can be very difficult to deal with, difficult to talk about.

I diagnose people with cancer, prostate cancer, bladder cancer, kidney cancer, things like that, that are also very stressful and kind of bring a lot of those things on.

And I do get to have these conversations quite frequently with folks about, "Hey, here's the deal. We can help you. There are things we can do and there are things you can do to kind of lessen this burden." Because sometimes when we diagnose people with cancer, we don't know the extent of things, and so it's having those conversations.

And I think, to me, some of these takeaways are I'm going to have a few extra tools in the toolkit to kind of offer options for them to try to help cope with some of these stressful situations and times of saying, "Hey, take a breath. Let's take this one step at a time. We know what we know right now," and try to help them through.

I do that on a regular basis, but I think I'll be more attuned to it now. And I think it's a great reminder as you go through to just continue to remember everybody's in their own place, a lot of this stuff is new, and doing it isn't always easy.

Scot: We didn't get a manual on this stuff, guys.

Dr. Smith: No. No one brought a manual.

Scot: No. And I'd imagine most of us didn't have parents . . . I think that's starting to happen now, but didn't have parents that would teach us how to even deal with this or identify it, right? We're just figuring it out as we go.

All right. Do you have a takeaway, Mitch?

Mitch: Yeah. So for me, it's just this idea that the same tools that I was learning to deal with my stuff that worked for me probably will work in the same situations of the uncertain times, right? And just recommitting to those when I'm starting to feel those, really focusing on identifying when I'm feeling overwhelmed, when I'm feeling burnout, when I'm feeling just stress in general, and trying to see if there are triggers, trying to see if there are things I can do.

It's always small actions that help us feel like we are more in control. And so picking some healthy ones and having a toolkit of things to try out to do that is fantastic.

Scot: I think, one, early in the conversation, just this notion that we talk about stress in blanket terms, and we talk about a lot of things in blanket terms, but really there's a lot more nuance. And today I learned there's a little bit more nuance.

Some stress is good, some stress is fine, and then stress from uncertainty, that's not so great and you do need to figure out ways to deal with that. I think that's super powerful.

And I'm going to keep coming back to this idea of these emotions and things that we feel are our body trying to tell us something. We just have to be quiet long enough or be contemplative long enough to try to figure out what that thing is. And I think we'll start making some insights about ourselves and then be able to start taking steps to make things a little bit better.

Dr. Hunziker, what do you think? What's your final thought?

Dr. Hunziker: I think you're right. I think the goal is not to avoid stress, right? The goal is to learn how to deal with stress. We can't stop the thoughts that jump into our head, but we can decide what to do with it once it's there.

And so doing those small things, those steady things, those things that keep us regular, keep the schedule, the daily movements, all of that stuff, that's what helps teach our brain that life is safe and can be predictable.

Scot: All right. If you're listening, I want to challenge you, because guys like a challenge, right?

Mitch: Oh, yeah.

Scot: Yeah. So try one small thing this week. Maybe there's something you've already known that's worked for you and you've forgotten about it. Maybe you learned about something here. Or better yet, if you're stressed from uncertainty, do it right now. You can do it in the car, on your ride home, before bed. Just give it a try.

If it helps, keep it. If it doesn't, try the next one. See if you can start building your own toolbox to keep your mental health healthy in times of uncertainty.

If you'd like to share and let us know how it goes or have any other health topics you'd like to see covered or just want to say hey . . . We always like a good hey.

Mitch: Love a hey.

Scot: It's hello@thescoperadio.com.

Thanks for listening, and thanks for caring about men's health. And guys, thanks for such a great open and honest discussion today.