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Episode 4: Anxiety: is it a natural feeling or a disorder
61 Plays2 years ago
Stephy Steph and Bobby look at a @wsj article by Dr. David H. Rosemarin about the new HHS guidelines on screening for anxiety. What is the risk for over diagnosis and over-treatment. The docs look at the issue through the lens of Integrative Medicine Fellows and clinicians.
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Transcript
Introduction and Setting the Stage
00:00:01
Speaker
Hey there, guys. I'm Bobby. This is Steffi Steff together. We are Between Two Teeth. Steffi Steff, what are we talking about today? You're going to hate this. Oh, my gosh. She moved the microphone. Yes, I'm going to hate that. That might cause anxiety, which, in consequence, is what we are talking about today. What do we get right into it?
Exploring Anxiety: Tools and Concerns
00:00:18
Speaker
What do we talk about? There is an article in the weekend edition of the Wall Street Journal talking about a new screening disorder or a disorder screening tool.
00:00:28
Speaker
And it's called the screening for anxiety disorder So this is an article by dr. Ross Marin. He's a professor at the Harvard Medical School and Bobby you want to kind of talk about how this General anxiety disorder screening tool kind of got off the ground
00:00:45
Speaker
You know, it's really interesting, and I'm glad we're looking at this. You know, you and I are both involved with the American Dental Association and their sort of wellness, well-being initiative, and anxiety is something that all of us face.
00:00:59
Speaker
pretty much all the time. And there's some healthy sort of things that come along with anxiety that can save your life. This author, you know, Harvard Medical School professor, he is a psychiatrist and his main concern was over diagnosing a normal condition.
00:01:20
Speaker
Certainly there's people that their anxiety becomes a disorder, but being anxious is a normal part of life. And all of this... So let's kind of break some of that down. That's a lot to unpack. That's a lot to unpack. Well, that's what we do with between two teeth. We unpack.
00:01:37
Speaker
So one of the things that struck me in this article were classic examples where we have had over-diagnosis or more diagnoses of some common ailments, especially in kiddos.
Integrative Approaches to Anxiety
00:01:50
Speaker
One of that being ADHD and then also being pain. So the problem with over-diagnosis, it's not because we are kind of promoting mind-body medicine and we're promoting stretching and healthy diet and exercise.
00:02:06
Speaker
The problem in America is that we give medication with a diagnosis. That's a really good point. And you and I have had the opportunity to both partake in integrative medicine fellowships and dealing with a lot of sort of mind-body interaction and appropriate diagnosis and appropriate treatments. And I think the concern here and the concern that we're sharing is you don't want to just reach to a drug solution right away.
00:02:35
Speaker
Right. So like with ADHD, any kiddo over the age of six with these very sensitive screening tools would be given Ritalin. Ritalin is highly addictive. It's a stimulant. Imagine getting your first strong double shot espresso at seven. Well, and here's the rub. In medicine, you have so little time with a patient that it's really easy to reach for a prescription pad
00:03:01
Speaker
as opposed to talking about things as far as the types of food people are eating, you know, I know there's some evidence as far as food additives being a bit of a challenge there and food diets for ADHD. Yes, and this is where, you know, they went into the context of the situation and what this author, Dr. Ross-Marin, was making the point that... Is that how you say his name? I had a hard time figuring out how to say it. Ross-Marin?
00:03:29
Speaker
was making the point that if you decontextualize what's happening. So for instance, if my dog died and I've been crying constantly, the context is my dog died.
Normalcy of Emotions and Daily Life
00:03:41
Speaker
But if you don't get a proper history, which is kind of what you're saying, and you decontextualize it, then I just cry constantly. So suddenly that looks different. And I think that's the whole point.
00:03:53
Speaker
There are times that it's appropriate to be anxious. Right, the good of anxiety. There's times that it's appropriate to be depressed. We are not supposed to be happy all the time and being unhappy.
00:04:10
Speaker
is a normal human emotion. Now certainly you can take things to an extreme and that can be a challenge. You need to come up for air. You got to come up for air. And I guess that's part of what we try to do with between two teeth. That's true. Are we trying to give people air? And even as clinicians, you know, we have people in our consults saying, hey, is this going to hurt? That's right. You are a periodontist and dental implant surgeon. I'm an oral maxifacial surgeon. We see people all the time that are
00:04:39
Speaker
You have these kiddos that are 1718 and they are high anxiety because they're wondering if it's going to hurt after and what kind of pain meds they can get the The one of the answers to explore is yes, it's gonna be uncomfortable afterwards because you had you had your teeth taken out and
00:04:58
Speaker
And so when we look at it in context, it's okay and appropriate to be sad sometimes, it's okay to not be okay, and it's okay to be a little uncomfortable sometimes. And there's a whole lot of information that you provided there to unpack. I would say back to the article, part of why this psychiatrist wrote the article is health and human services came out with some new guidelines. They had published some guidelines on screening for anxiety. Their recommendation was that primary care physicians should do
00:05:28
Speaker
question sort of screening tool and this the author of the article said hey man you're gonna you're gonna cause too much treatment you're gonna cause too many people to be looked at under the guise of is this an anxiety disorder versus just regular anxiety and to your point as you talked about earlier
00:05:52
Speaker
You know, that's happened before with opioids and pain medication. And the author said, you know, benzodiazepines is a class of drug, Valium, uh, Ativan. Those are common benzos that are used for anxiety, but do we don't really want to go to that part?
Personal Experiences and Triggers
00:06:11
Speaker
So, you know, as we kind of talk about, I think we've, I think, I think we've made our point here of we don't have to over diagnosing something is not necessarily the correct way to go about, no, it's terrible. Overdiagnosing is terrible. Other than if you're going to have a hair trigger for
00:06:30
Speaker
anxiety diagnosis. One of the points this author was making was that he was actually feeling anxiety as he thought about over-diagnosing anxiety. And the point with that was that if you think about something constantly you are much more likely to have a disorder from it than if you can have a balanced thought rubble. So what what makes you anxious?
00:06:57
Speaker
I get anxious over a lot of things. What makes you anxious? That's called deflecting. So I'm going to talk about something. I don't want to talk about how you deal with anxiety. I want to talk about what makes you anxious. That was the question. So I had a point in my professional career that I was anxious sedating patients. And I had been involved on a sedation safety panel
00:07:22
Speaker
and looking at some challenges from a sedation safety standpoint. So I had seen all kinds of data and it made me anxious and I would be anxious driving into work each day.
00:07:34
Speaker
For me, I think I get anxious about if I am doing enough, if I am growing and challenging myself enough. And I think that's a very common, commonly shared kind of anxiety producing emotion or kind of etiology, especially when you have
00:07:54
Speaker
I mean, especially when you have someone who's gone through higher education and they've got that incessant need to just kind of produce and create things or just kind of be valuable to society.
00:08:11
Speaker
What else makes me anxious? I get anxious, you know, we have a pretty big thing coming up in a couple months. I'm trying to get healthy. I'm anxious that I'm not going to fit into a wardrobe item that I need to to be on stage.
00:08:26
Speaker
That is, that is absolutely anxiety producing. I remember, I remember just kind of being, this is kind of like, did you ever get anxious about races? All the time. Cause you were, you know, I hate to brag for you, but you were a big time.
00:08:42
Speaker
So running absolute champion running running absolutely induced anxiety within me. However, the crazy thing was once I started the race, it was the antidote because running.
Anxiety's Role in Performance
00:08:56
Speaker
I decreased that anxiety. You keep pointing to something with your pen. Well, I just have a pen in my hand. I like pens.
00:09:02
Speaker
And so that's the thing though. As you say that, as you say that, I look at it and say, that probably actually helped out. If you're an athlete, you're showing up for a race. If you're just chill and you're just like, hmm. It was a crazy mental cycle because you'd get so nervous before races because from my experience, I wanted to win some of the races I was supposed to win.
00:09:35
Speaker
In talking about anxiety and what it does physiologically, she's laughing. I never ran a day in his life. No, no, listen, I ran. We're going to brush past your biggest childhood trauma. Listen, I'm starting to do a little touch of running to try to get me in a good spot. Yeah, about that. Yeah, totally get it. You are nervous to four arrays. Totally. I need to get a track athlete on here so we can really impact this. Totally different podcast on that. Steph's got this running plan for me that's for like an 18-year-old high school student or something. But I want to read,
00:09:57
Speaker
And that was a lot for a 14, 15 year old.
00:10:04
Speaker
We actually get the newspaper here. I'm ready to hear about your childhood trauma so I can disregard it. I love holding the newspaper in my hand. But I want to read what the author says here. Are we reading? Yes, I'm going to read. I'm going to read from it. All human emotions, whether positive or negative, serve a vital function. And anxiety is no exception.
00:10:23
Speaker
Common anxiety symptoms include a rapid heart rate, increased breathing, muscle tension. No, no, don't stomach ache and feeling on edge. No one likes when you read on a show like this. And I can't believe you just read for that long. And you are making a point that we've made. Are you done?
00:10:48
Speaker
What did you just read? Can I continue? What did you just read? So summarize it. I'm going to summarize it. There are, well, the article's really a good article, so I wanted to capture everything there. Physiological things happen. You and I are surgeons, and we see people that come into us. Are you OK with your eye? I had to bring up running again, but I could talk to you all about how emotion and physiology are connected. OK, yes, but that's the point of it.
00:11:12
Speaker
When you are under stress, the fight or flight response, the sympathetic discharge says, Hey man, I got to get prepared for something. Yes, it does. Heart rate goes up, blood pressure goes up, your muscles are functioning properly. It's a heightened sense of awareness. Actually, sometimes your muscles don't function properly. There's fight, flight and freeze.
00:11:32
Speaker
That
Coping Mechanisms Across Contexts
00:11:33
Speaker
is true. Is that muscle or is that psychological? Well, your muscles don't move. So the cool thing with that is you have anxiety and then you have in the article they mentioned the Ukrainian-Russian war right now and they said that even though Ukrainians who were
00:11:53
Speaker
well adapted with a lot of anxiety, they were more likely to survive a battle, maybe. That's what they talked about. They were also more likely on the backside of things, because when you do have anxiety every day, they were also more likely to develop post-traumatic stress disorder. Once the stressor goes away, that's where it can be tricky.
00:12:16
Speaker
Right, which gets into another article that is parallel to this. Yeah, and it might have been a podcast. Are you keeping articles from me? They talked about, no, they talked about a bunker that I was getting
00:12:31
Speaker
bombed and they had three age groups in there. They had infants, they had kind of teenagers and they had adults, middle-aged adults. And as the bunker was bombed, you got to see how people dealt with stress in a real way. The infants just shook. They would literally just shake in their, their parents' arms.
00:12:52
Speaker
you told me about the middle or the kiddos like the teenagers they would shake a little bit but they would try to hide it because it's not socially appropriate to shake especially if you're a boy and then the adults would be stone cold the the the lesson here or the interesting point here
00:13:10
Speaker
Is that anxiety we know we need to hide anxiety We know we need to deal with it because that's just kind of what society teaches us numb the anxiety Don't let it out. Don't let it show but if it's what society tells you but if you look in nature a deer doesn't have PTSD After almost being struck by a car a deer will actually freeze on the road right in front almost get killed Shakes and then goes away that shaking is how they cope positively awesome when you told me about that
00:13:40
Speaker
Yeah, what you don't see is the deer getting ativan right after and seeing a psychologist. That's a study between two teams you do. We've got to figure out how to get ativan into the deer. And if you monitor that deer's vitals the rest of their life, you would never know that they had this super traumatic incident. They shake it off. They literally shake it off. Even if they have it at a very young point in the deer's life, it doesn't matter because in the animal kingdom, at least with
00:14:11
Speaker
With with most animals they have a physiologic response They don't think they're not aware of always what's this emotion like? So what I would say there are times you're comfortable with being uncomfortable Yes, and there are times that as humans we get in our own way
00:14:29
Speaker
So let's talk about, I agree with that. So speaking of getting in our own way, I would say one of those is human beings in an effort to help and or to make money will tend to over-diagnose and have multiple prescriptions and medications. So let's use our integrative medicine experience and talk about the ways that we deal with anxiety or cope in a sustainable way.
00:14:55
Speaker
Okay. I would say the overarching principle here is to realize that some element of anxiety is appropriate and normal and not a medical issue.
Managing Anxiety: Techniques and Tools
00:15:11
Speaker
So that's kind of the overarching thing.
00:15:14
Speaker
As I get into from an integrative medicine standpoint, the number one thing I think, which is the low hanging fruit, I do this myself, I talk about it with my kids, I talk about it with patients, are breathing exercises. Do you know how to breathe? I don't know how to breathe well. I actually have sports induced asthma. Thanks for bringing that up again. Oh, sorry.
00:15:35
Speaker
I agree with you on the breathing, breath work. Low hanging fruit. Yes, I think one of the superpowers for Gen Z will be how do positively adapt to the ever increasing anxiety that this world creates.
00:15:50
Speaker
And I would say that because of wearables that are monitoring your breathing rate, your heart rate, your heart rate variability, people are in tune with that. So it actually creates more anxiety. Okay, it can. Yes. And the nice thing is because you're somebody I think that sees that data and goes,
00:16:11
Speaker
awesome. How can I fix this? But some people I get a little anxious if so if my my sleep eight bed, which is a bed that tracks your sleep, if I wake up with a sleep score less than 99. I'm like, Oh my god, can I pause you? So I agree, you can have data overload.
00:16:30
Speaker
And there's times I know you as a runner, you have the Garmin watch. There's times I think that you take the watch off for a period of time. I've just learned to, I've learned in a really tough way to just shut down the numbers. Don't worry about the numbers. Put things in perspective. Use data to help you. Don't let data sort of make you go amok, but let's get back to breathing exercises. Here's what we're going to do. I'm going to, I'm going to do a breathing exercise with you. 4-2-8.
00:17:01
Speaker
or there's four seven eight is another. Is it four seven eight? Seriously. That's probably the reason they haven't got the message out. Well, and so there's, there's a very one. Is it four seven eight? It's four seven eight. Are you sure? Yes. I'm a hundred percent sure. One of many breathing. Well, it is early in the morning. People only had a little touch of coffee, but, but that actually makes a good point. There are several different things. And when I'm talking to patients, I usually say, find something that works for you. We actually hand out a,
00:17:31
Speaker
something from the Integrated Medicine Fellowship to the patients that has a very specific type. I actually don't use that one myself. That was a good start. But with breathing, it is the magic's in the exhale. Yes, the magic is in the exhale. Are you prepared to do a breathing exercise right now? I don't know if we should get into the nitty-gritty on breathing exercise, other than to say... Well, I said we're going to do one. I'm going to demonstrate one. I'm going to slow my exhale.
00:18:02
Speaker
This makes for great podcasting. We're going to listen to Bob breathe into the microphone. Yes, that was a slow exhale, but there's magic that happens. It's a sympathetic. So I absolutely agree with you. If you can, so I think a better, sorry to cut you off just for a second. I think a better thing is I think for, I think a better way to describe this is understand that your, every emotion has a physiological response to it.
00:18:31
Speaker
and breathing, you can actually change your physiology by slowing down your breathing. Try it. And it doesn't have to be perfect. You don't have to do four, seven, eight breathing. It is a technique, but just to test out the changes that happen when you are having a, say you're having a panic attack or say you're having a lot of anxiety, take a deep breath and see what that does for you. Yes. I would say get online, look at some types of breathing exercises, try them before you're having a panic attack.
00:19:01
Speaker
But get good at it. It's just like practicing in the gym. You get better with time. Second thing that I really found to be helpful is meditation. That's something I didn't meditate until we did the, until I did the integrative medicine fellowship. I thought it was hokey. It's hard for me to meditate. It's easier for me to journal and maybe the two are the same.
00:19:25
Speaker
There's a lot of positive data on journaling, but I want to stick with meditation for a second. I never thought I would be someone that would meditate. I needed me personally. I needed an app like Headspace.
00:19:44
Speaker
or calm, I've used calm a little bit, but Headspace, the guy's voice, Andy's voice, I just absolutely love, we are not sponsored by Headspace, but we would love to be sponsored by Headspace. But it works for me because it's effective. Finding something that's gonna work for you, maybe it's an app, maybe it's not an app, I think if you're trying to meditate, I think the low-hanging fruit is trying an app, but it allowed me to really kind of down-regulate some of my sympathetic discharges.
00:20:11
Speaker
I like the Headspace app. I'm not someone who can sit still very well, but I'll say that, yeah, that's part of, I've got a lot of energy. No, I just have a lot of energy and I have to eke it out, especially, I don't know, like especially once I've had, I've had some coffee, like I can't sit still or I choose not to sit still. You're very sensitive to caffeine.
00:20:38
Speaker
And that's actually something I I've had a point where I've had too much coffee or tea and it made me physiologically anxious
00:20:48
Speaker
Yeah, agreed. And for some people, that's maybe part of it. You know, I know stimulants are kind of the big thing, these energy drinks and all that kind of jazz. There's a lot of data to suggest that you can have physiological changes, especially the crash after a whopping amount of caffeine. Yes. You know, for me, I have to really focus on staying hydrated in the summer because, you know, caffeine is not only dehydrate you, but it also like, I recognize that I have a lot of caffeine.
00:21:17
Speaker
that my day, it's like a gradual uptick and then down.
Exercise and Mental Health
00:21:23
Speaker
The only thing that is consistently provided a much more balanced energy level for me is exercise. Yeah. And that's really one of the main points. You know, I was listening to a great podcast with Rich Roll and Tim Ferriss, two people that we both follow quite a bit.
00:21:43
Speaker
And Tim Ferriss was talking about his struggle with mental health issues, including depression, including anxiety, including suicidal ideation.
00:21:53
Speaker
And he said for him, exercise was his main thing that if he had to choose between an antidepressant and exercise, he would go with exercise. You need to get more sleep. No, not at all. I'm just going to start pointing at random things while you're trying to make points because that's what we're doing right now.
00:22:13
Speaker
Right, so exercise has been awesome for someone like me because it was part of the reason I didn't have to have a medication when I was in high school. And so what that means is ADHD runs in my family. That's why you don't get to touch pens. ADHD runs in my family and I think it's definitely over diagnosed probably in my family.
00:22:37
Speaker
And as a kiddo, you know, my brother could not sit still in class to save his life. And I think and that negatively impacts your options after high school, because if you can't sit still and you can't make the grades, then it really does. It just it limits your options. So can I continue my story?
Understanding Anxiety Disorders
00:22:58
Speaker
OK. Thank you. So for me, I just happened to luck into running at the time and it really enabled me. You have lost pen privileges.
00:23:06
Speaker
It really enabled me to focus. I hear you on that. And I think one of the things that steps outside of this article is there are people that have true anxiety disorders. And I think what we've talked about is breathing, meditation, exercise, quite frankly, going through a tricky time
00:23:35
Speaker
So how would you define an anxiety disorder versus just having anxiety? So I'm not a psychiatrist, so I'm not even going to go there. And none of what we're talking about constitutes medical advice. Right. And this is not medical advice, but I will take a jump out on this limb, is that a disorder usually has to do with chemical changes in the brain that affect the function of day-to-day life. Yes. And that's where it gets down to affecting how you move through this world.
00:24:05
Speaker
It's often the same time with depression. It's okay to be depressed, but clinical depression comes with a different diagnostic set of data points. And I think if there's concern, you get to an appropriate healthcare provider and they diagnose. And so this kind of breaks into this overwhelming topic. I know you serve on the Dental Wellness Access Committee. I'm not sure if DWAC is... Dental Team Wellness Advisor.
00:24:35
Speaker
Dental team wellness advisory and I'm a wellness ambassador this year and one of the big Topics of discussion is where is your entry point when you are trying to help people? Because you have you have a big range if you look at mental health and well-being
00:24:53
Speaker
Where is your entry point? Which big group do you really focus all of your pamphlets, all of your discussions on? Do you focus it on the group that has no challenges at all and just teach prevention, purely prevention? Do you go a little further down the line and say, hey, you're a college student, you're a dental student?
00:25:13
Speaker
you're drinking a lot on the weekends that's okay though because you're young and that's what young people do is that where you hit the the addictive potential there or do you go a little bit more into the career where people are having divorces maybe their kids have died maybe they have parents that have died and they're really starting to deal with
00:25:32
Speaker
uh, some of this depression, anxiety in a very, um, daily kind of limiting way. Or do you go to the very end of that where you start to get, uh, you know, things like thoughts of suicide, uh, kind of attempts at suicide, even different messages for different groups. And I think as I hear you talk there, it gets down to mental health is a continuum. And you kind of gave the, the markers on,
00:26:00
Speaker
one side versus the extreme the other side and people move throughout that space in different messages for different people along that journey. I know part of Between Two Teeth is for us to share our own journey as we move through time to talk about things that concern us. You know this article, why did this article pop up to you at all? What
00:26:28
Speaker
Was there any meaning about, because when I looked at it, I looked at it and said, yeah, I see anxiety right now in society. You know, part of the reason this article popped up to me is because of what I was, I was just saying as far as where, where's your entry point on the continuum. And when you read an article about over diagnosing anxiety, it's, it's an author that's saying this entry point may not be the right one.
00:26:54
Speaker
And it's kind of calling out, you know, big pharma. It's calling out healthcare providers that are overworked and they don't have the time to really have a good diagnosis. So they need a screening tool. That's a hair trigger. And not only on the diagnostic side, but on the treatment side.
00:27:13
Speaker
Yeah, and it's also calling out and that's the big pharma thing and you know, we live in a We have I took a Harvard surgical leadership program and finished it up last year it put me in rooms with people who Are in different countries and they have a different experience with healthcare. It's not all capitalism and with capitalism
00:27:35
Speaker
it's about making money in the guise of health care which it complicates things because there's a Nuance to what what is our interest?
Communication and Anxiety in Healthcare
00:27:44
Speaker
Yeah, and this is one of those things that this author is just kind of calling out saying why are we giving the okay for Copious amounts of benzodiazepine prescriptions breathing exercises are free
00:28:00
Speaker
It's not, it's not necessarily about the cost. They are free. So you know that they're not, there's no, no one's trying to make a buck off you by telling you to breathe. And that's what I tell patients. I'm like, this is free. You can do it anywhere. You get better at it the more you practice. Yes. And the stigma with that is that it is, it is magical. It's yeah, it's magical woo. That doesn't work. The crazy part is right. If I had a dollar for every time a patient said that,
00:28:25
Speaker
Part of the reason exercise helps you is because it changes your breathing. It makes you breathe different. And a lot of these four, seven, eight breathing techniques, I think there's something called lion's breath, all of these breathing techniques that I discovered during yoga sessions, I didn't know about, and through the integrative medicine fellowship, it all has to do with physiologic change in your breath work. When you run, you absolutely change your breathing.
00:28:51
Speaker
Well, and as I'm treating patients, I will often say, if you'd like to feel more comfortable, what we found that helps patients is just try to slow down your exhale as you breathe out. There's a distraction component, so it's a cognitive issue, and to your point, yes, a physiological issue.
00:29:11
Speaker
I started playing around with breath work when I was 14 and it was out of necessity. I have sports induced asthma. And so if I didn't psychologically tell myself, okay, I have got to control my breathing, I would not have enough O2 going to my muscles. So I had to literally slow down my breath work most runs.
00:29:32
Speaker
It literally gets to be a big deal. You know, the diaphragm muscle itself is connected to the, the vagus nerve and part of the parasympathetic nerve system. So physiological things certainly happen and you're not going to be a peak performing athlete if you don't sort of have control over that.
00:29:49
Speaker
Maybe that's my problem. Also think about singers. They sing from their diaphragm. Totally, totally. To project their voice and that in one breath, it slows down your breathing. You're also getting out this emotion. One of the books I'm reading right now on human nature talks about the natural tendency of aggression in humans. And humans have to get out this energy. They have to get out this aggression. Not everyone's hyper aggressive, but not everyone's a leaf either.
00:30:15
Speaker
You and I are developing communication talks for health care professionals and part of it is to decrease patient anxiety and to have appropriate patient interactions.
Parental Influence on Anxiety
00:30:28
Speaker
Part of it is also quite frankly to try to heal the provider that ties in with some of the things that we're doing with the ADA Wellness Initiative.
00:30:38
Speaker
I would push our listeners just to get some tools in their toolbox. If you've never done breathing exercises, get online and check it out and give it a go. And know that some things are going to work for you, some things won't, some things, you know, it is good to have tools that you can utilize.
00:31:01
Speaker
You know, and also realize your kids are watching you. How you deal with anxiety is going to set the foundation for how they will deal with anxiety. That's a terrific point. When we treat patients and we see a lot of teenagers and we're giving them IV medications to help relax them, which has become more difficult in the past several years, especially post COVID. That's part of my interest in this article. We'll go out and see the parent.
00:31:30
Speaker
And oftentimes, if the kid's been super anxious, the parent is on the edge of their seat, their eyes are wide open, full fight or flight sympathetic discharge. And I'm not to belittle your kid going through a surgical procedure is a big deal. There's just a different way to communicate love and care. But there's different ways to deal with anxiety and stress and
00:31:57
Speaker
We want, we want people to live their best lives. That's what it comes to. You know, my, my little, I agree with you and my little rant on that is, it is just that I think today and I get it, the parents always say, Hey, when we were going to the dentist back in the day, it just wasn't what it is today.
00:32:16
Speaker
And they've even said we're trying not to pass on that anxiety to our children, but it's tough. And I get that it's tough, but here's the deal. Life is not about feeling no pain. That is not what it's about. Life is about experiencing the cornucopia of emotions that come along with it, including pain.
00:32:35
Speaker
And I think it's parents and generations. Can you finish? Yes, parents and generations. I'm trying to do something. Parents and generations, they've tried to shield their kids from pain completely.
Conclusion and Community Engagement
00:32:48
Speaker
And so whenever you're going through something, especially when you know you're going in for a procedure, pain is not the end point. Pain is part of the journey and that's okay. The end point, think about it, is getting healthier. That's what you need to focus on.
00:33:03
Speaker
And just realizing there's times in life where you're going to be anxious. You just focus on the wrong thing. There are times in life where you're going to have pain. There's times in life where you're going to be happy. Focus on the long term. Focus on the long term.
00:33:21
Speaker
results versus the temporary part of the journey. Yeah, I agree. Well guys, thank you so much. This has been another episode of between two teeth. We, we love having you guys listening and please leave comments. Uh, if you want to hear something that we're not talking about, if you want to know more information of some of the stuff we mentioned, please give us a shout. Thanks guys.