April 29, 2021

Pandemic Stress: How It’s Impacting the Emotional Well-Being of Women

Show Notes

On this episode, Chuck Gaidica is joined by Dr. Amy McKenzie, Associate Chief Medical Officer of Provider Engagement for Blue Cross Blue Shield of Michigan. Together, they discuss how the stress of the pandemic has had a significant toll on the emotional well-being of women.

In this episode of A Healthier Michigan Podcast, we explore:

  • The challenges women have faced throughout the pandemic.
  • The difference between emotional labor and emotional work, and it’s weight on mental health.
  • Changes in health behavior due to stress.
  • Ways to overcome negative feelings and resentment.

Transcript

Chuck Gaidica:
This is A Healthier Michigan Podcast, episode 79. Coming up, we discuss how the pandemic has taken a significant toll on many women’s emotional well-being.

Chuck Gaidica:
Welcome to A Healthier Michigan Podcast. This is a podcast dedicated to navigating how we can all improve our health and well-being through small, healthy habits we can start right now. I’m your host, Chuck Gaidica. Every other week, we’ll sit down with a certified expert to discuss topics covering well-being, mental health, and a whole lot more. And on this episode, we’re diving deeper into the impact of emotional work and what it has on women experiencing it daily. With me today is Dr. Amy McKenzie, who’s the Associate Chief Medical Officer for Provider Engagement with Blue Cross Blue Shield of Michigan. Dr. McKenzie, good to have you with us.

Dr. Amy McKenzie:
Thanks Chuck. It’s good to be here today.

Chuck Gaidica:
Well, I know you’ve got a rich, deep background, taking you all the way back to school and you’ve been a provider of healthcare and you’re also a consultant. But give us some perspective on this idea that we’re talking about today, because as we look at this, there are so many sources that are now showing that there could be an issue. According to a recent article by WebMD, this last year has taken a bigger toll on women’s mental health more so than men. A study published by Frontiers in Global Women’s Health found that women were reporting more anxiety and depression with their symptoms worsening over time while in isolation. So with research pointing to increased stress in women throughout this time, what can we do to be more mindful of those in our lives? Better yet, what can the women do who are experiencing this to do, and maybe express the unbalance and ask for help from all of us around them?

Dr. Amy McKenzie:
Yeah, it’s absolutely a great question. And Chuck, you’re absolutely right. The last year, for all of us, COVID-19 has just changed life as we know it, in both big and small ways. And what we know about change is that changes something that can create stress, even good changes in your life. But the magnitude of the number of changes can build up over time and create stress. And for women in particular, the last year has created just a number of challenges. Many of the women in our society are in primary caretaking roles and have responsibilities with children or elderly parents. And when you look at what the pandemic has brought, many of those children have moved into virtual school environments where they needed help with their schoolwork. And so you have parents who were juggling responsibilities at work and also helping their children in a very different way over the last year.

Dr. Amy McKenzie:
And then for many of us, we also have elderly parents or grandparents who, a much greater risk of serious illness. And so they needed help. They couldn’t go out to the grocery store, they needed groceries delivered, all of those types of things. So that has really, as you mentioned, created a lot of risk, particularly in women who are in some of these caretaking roles of anxiety and depression and all sorts of things. So in terms of the second part of your question of recognizing this and reaching out for help, it’s just so critically important to have those conversations like we’re having today about, what can women do in our society to be able to reach out and start those conversations and ask for help when they need it. Because many times, women will put themselves bottom on the priority list. They feel guilty for taking time for themselves because they’re always helping others.

Chuck Gaidica:
It seems like you can’t, in a time where life seems to have slowed down for many, the pressures you’re talking about are not just self-imposed right? These are so many different, strange changes. And yet to find emotional health sometimes means we’ve got to dial down the noise of life. We’ve got to find some quiet time to allow us to listen for our intuition, listen for just some peace and quiet, and that’s been tough for so many families and people.

Dr. Amy McKenzie:
It absolutely has and you’re absolutely right. A key part of being able to support, not only your physical health but your own mental health, is dialing that noise down, taking time, stepping away, doing things that you find that bring joy and peace to you. And that can look different for different people, frankly. We have good evidence and science behind a lot of different techniques, things like mindfulness or breathing, yoga, exercise, taking some time outside, a walk, being in nature, are all things that can help. But for different people, that can look different. Some people, being mindful can be putting together a puzzle, maybe if you enjoy cooking or spending time with family, friends in a social environment where you’re not in that caretaking role. So it’s just important to do things that feed your soul and allow you to have that space to step away and decompress.

Chuck Gaidica:
Yeah. And there are new terms that are popping up, like in normal life even prior to the pandemic. We had new phrases come into our life like binge watching, right?

Dr. Amy McKenzie:
Yeah.

Chuck Gaidica:
We got all kinds of interesting things on the upside, but now we’re hearing terms like emotional labor and emotional work. They’ve been surfacing more and more. Would you explain what emotional labor and emotional work is and what the difference is between the two of those phrases?

Dr. Amy McKenzie:
Yeah. So emotional labor is a term that actually was coined quite a number of years ago, but has been coming up, as you mentioned, in recent articles. And it was originally defined as really the work around managing your own emotions in order to be able to meet your job requirements or influence a positive experience for those that are around you. Let me give you a couple examples of what that looks like. So it can be seen oftentimes, in certain professions, you liken it to that service with a smile type of situation, right? So it could be if you’re a nurse and you’re taking care of your patients, you can imagine that they get tired, hungry, they may be having a bad day, but you still have to perform your job and do it in a way that is helping to meet the needs of someone else. And so that requires that you are somewhat pushing down some of your own emotions or challenges that you’re having during day, and that carries some stress around it. So that’s really what the term emotional labor really gets at.

Dr. Amy McKenzie:
Now, when you get into emotional work, this term has gradually expanded over time. And that starts to recognize all of the unpaid and invisible work that goes on within our society. That’s part of that caretaking role, the job after the job or the second job after you get home of all the things that we have to do in life that many times are falling to women of child rearing, preparing lunches, taking the dog to the vet, picking up medications, but then also providing the emotional support for those that are in our lives from parents to children.

Chuck Gaidica:
And it seems like there’s a circle there between them because you can imagine as a mom or a dad, but we’re speaking about women here in particular, you’re thinking about this idea that you may be pushing down your own emotions and you’re having to wear that mask, that smile, that honey, kids everything’s going to be okay, and we’re going to come through this. Yet, you’re ruminating on the stuff that didn’t go well today or what you’re fearful of yourself. So you are pushing this stuff down and that’s got to be taxing on the brain, on your entire body, right?

Dr. Amy McKenzie:
That’s exactly right. There’s some good studies out there that look at where they’ve surveyed men and women, that women tend to have more empathy, which is where you really resonate with others’ emotions. And putting on that mask, though, it can be taxing and it can have a toll. And part of having that more empathic view of the world comes with the increased risk of things like depression or anxiety associated with it as well.

Chuck Gaidica:
Yeah. Sometimes I have such good intentions, I get into the drive-through of some fast food place, and I’ll say to somebody, “Have a nice day,” and they’ll typically respond. And as I drive away, I think, well, I’m trying to be nice, but how many thousands of times a day are they having to put on this mask of friendliness because they’re being paid to, to say, “Hey, here you go, have a nice day.” And I just think, “Wow, I wonder how they’re really feeling?” And so there’s a connection point you can see in different places, but you don’t really think of it manifesting in the home or in your family life. But what you’re talking about seems so ever present for many.

Dr. Amy McKenzie:
Yeah. I think that was a great example that you just provided. I actually had an experience where we were out the other week, having breakfast, socially distanced, everybody had their masks, but we saw that the waitress was very, very overtaxed and really running hard. And someone at our table said, “It’s okay, we’re not in a hurry.” And you could just see the letdown from her. So we all carry this. We all have things that we’re trying to balance with our workplaces and home. But keeping up that mask all the time, it can be very taxing.

Chuck Gaidica:
What are you seeing and what connections are you finding of how emotional labor and work are affecting the emotional, mental, even physical health of those who are feeling the weight of life and experiences right now?

Dr. Amy McKenzie:
Yeah. So emotional labor can take a number of different outcomes. During the last year, I think it’s, as we talked about, we’ve had particular circumstances that have been very challenging and it really depends on your situation. For some, if you have social support in place and division of labor in the household, that can be really helpful. People who have a significant other living at home or are employed, they are a little more protected than others. But those who are single, those who are struggling in lower socioeconomic conditions or just challenges in balancing family life, you really can see risk of people having, as we mentioned, symptoms of depression, symptoms of anxiety. Sometimes even symptoms of PTSD. If you imagine those who are on the front line workers who are out there, who may have been worried about getting the virus, bringing it home to their family. A lot of our healthcare workers are women and had these daily concerns that they’re dealing with over the last year. So those are all types of things that we can see with this emotional labor.

Chuck Gaidica:
You’ve said it in a couple of different ways, but we men tend to not only hear this, but it’s likely very true how we put off our healthcare. We don’t go get a physical. It’s once every three to five years, it’s not every year, right? So that’s probably a broad brush. But for women, do you see that they’re putting on hold the attention to their own health care then because of what we’ve been going through and the everyday challenges that they’re facing?

Dr. Amy McKenzie:
Many have. As all of us, when our lives get busier and the demands go greater, usually certain things that are really important we set to the side, and oftentimes, that’s our own health. And so we have seen, there’ve been some good studies out there showing that up to 95% of people are showing some sort of negative emotion in the last year. And also changes in health behaviors have been reported. Some of those are good, some people have adopted new exercise routines. But I would say a significant portion are reporting behaviors like coping behaviors, turning to food or turning to alcohol. We’ve heard about people gaining weight. We’ve also heard, on the really severe end, things like more domestic violence in the home and more substance use disorder on the rise as well, just out of the strain of coping. And oftentimes, that’s because people are deprioritizing some of their health behaviors and turning to other means as they’re working to cope with the emotions that they’re facing.

Chuck Gaidica:
Yeah. And we’ve talked about before, in different ways, on this podcast, the idea, the analogy anyway, of being on a jetliner and God forbid, something goes wrong and the oxygen masks come down. If you don’t put your mask on first in your family, you’re not going to be able to help the others next to you in either seat, right? You’re just not able to help. They even tell you that, “Put your mask on first before you try to help a child or somebody next to you.” And it’s counterintuitive because especially as a parent or a caregiver, you just want to rush in, you want to help. And yet, if you’re not taking care of yourself, you’re not going to be as well equipped to take care of those others that are relying on you, perhaps.

Dr. Amy McKenzie:
You are absolutely right, and that’s actually one of my favorite analogies and one that I’ve used in multiple talks that I’ve given as well, is you really do have to take care of yourself because you will burn out. And then you are not able to perform as well and take care and do all the things that are important to you with those that you love, or those at your workplace. You just can’t be your best self if you’re not taking care of yourself.

Chuck Gaidica:
What steps should we be looking for, for overcoming these negative feelings and maybe even a resentment that builds up, this notion of emotional labor and work? What should we be looking for, for ourselves individually and then for those others in our home? Could be senior parents, even down the block, but what should we be looking for then, with others around us?

Dr. Amy McKenzie:
Yeah. So I think what’s really important, and we mentioned it a little bit during this time, but it’s really prioritizing, right? Prioritizing yourself. And it doesn’t have to be real long, but you do need to find time for yourself every day to be able to take care of yourself, whether that be through mindfulness, a walk, spending time with those that you love, finding something that you enjoy doing, getting enough rest. I think we sometimes don’t think about that, but when you aren’t getting enough rest, you tend to wear down as well and everything becomes much more stressful and poignant. Following a healthy diet, those are all really important ways that you can take care of yourself.

Dr. Amy McKenzie:
The other piece though, in terms of building up resentment is opening up the dialogue with those around you, tapping into those, many of us have people who are willing to help out in our lives, but it’s many times that we’re not reaching out and having or engaging in those conversations. When you do that, you have to be willing to delegate to others, to allow others to do things their way. Perfection’s not the goal, but really tapping into that support system and telling people how you’re feeling, the strain that you’re under, what it is that you need and where you need help, I think are all critical parts of dealing with this.

Chuck Gaidica:
And in this time that seems to have followed right along with the pandemic, of course, but then we’ve had news of the day that causes emotional stress and other things, finding community has been really tough, right? We just haven’t been able to go to places that were typically where we would gather. We’ve got a daughter who’s expecting a baby at the end of June and she’s found a mom’s Facebook group, right? So one of her outlets, outside of speaking with her husband and family, is that as a new mom, expectant mom, she has a community, as virtual as it may be, that’s asking questions. And if they have some angst about something that’s coming, they’re all kind of in the same boat. They’ve never had a baby. Well, there are other ways for us to find community. And I think that’s encouraging to me, even if you extrapolate that to other walks of life. We can find collectives of people or hobbies, people who love gardening, right, as we’re getting into warmer weather. I think we have some opportunities there.

Dr. Amy McKenzie:
I 100% agree. I think that the unexpected in all of this is that it has forced us all to learn to communicate in different ways. You many times saw families across the country that maybe were having phone calls periodically. But now I hear people that are getting their families together over a Zoom and having a Zoom birthday party. And I think that that’s actually a benefit. Of course, being in person is always wonderful and there’s nothing like having that hug. But being able to see people and have those conversations over some of those virtual tools and the complete expansion of those and the opportunities there. I think what your daughter’s doing, finding support groups, others who feel like her, who she’s able to communicate and share some of those concerns and also get feedback on that, those are all great tools and ways to be able to deal with the strain.

Chuck Gaidica:
Yeah. Are there specific suggestions for support systems? Are support systems the answer? And if so, how do we create them? What can we really do to put something in place that’s going to work for us? And I know it’s based on context of the person, but what are your suggestions about creating support systems as we kind of limp our way out of this pandemic, hopefully?

Dr. Amy McKenzie:
It’s a great question. And it is different by the person. For some, their support systems, they have their family or their friends can be their key support system. But for others, there are community partners that you can reach out to. Really you’re looking for others that have a shared experience. We know that it’s very, very helpful to have conversations with others who have similar experience. That’s why I think your daughter’s example was just so wonderful. Especially for those who are having this emotional labor and going in and having to put on that face, you need time to decompress with others who have similar experiences. So finding those at work who have a similar experience where you can pull up, have some coffee time, it does take effort. It requires that you outreach, it requires that you are looking for those folks. But they are out there and many are feeling like you. And so knowing that you can reach out and that people are generally quite receptive and also looking for the same thing.

Chuck Gaidica:
I use that example of my daughter and even my son-in-law because of expecting a baby. And for the most part, to my knowledge, this has been a very positive experience for them. And even finding support group has been a very positive, uplifting thing, asking questions that they’ve never had to ask before. But then, even if you think about this, where it’s a single person, a single woman living in a home, don’t have the worries of caregiving perhaps, don’t have aged parents to think about, even the notion, as I’m thinking about this, of having all the time and all the quiet time that we’re talking about sounds like an upside could actually be one of the problems for them, right? They’re ruminating over something, the broken record is just playing about, “What I’m worried about, what I’m worried about,” because they don’t have distractions. So to point about finding these outlets, creating distractions is going to be good for some who don’t have them in the house either.

Dr. Amy McKenzie:
Absolutely. None of us can do life on our own. Finding the community of folks who you feel connected to is just such an important part of our overall way of being able to help with our own mental health and being able to help have that shared experience, it can really help in this journey.

Chuck Gaidica:
So if we’re in a household where parents, or even it’s our own parents or it’s our spouse, whatever it is, how do we sit down and deal with what we’re now seeing? We may not be capable of diagnosing PTSD and we’re not trained in positive psychology, but we sure do love those people and we want to help them. How do we create a conversation, a healthful one that tries to help move them and maybe even us along to a place of change?

Dr. Amy McKenzie:
I found that being transparent and being willing to open those conversations. I think a lot of people shy away and are concerned, like “If I ask about this, am I prying?” But many people feel grateful that you’ve asked the question, “Are you struggling in this way? Is there something I can help you with?” And just reaching out and having those conversations. And if you’re having feelings, being willing to reach out and have those transparent conversations with others around you on what you’re struggling with, it just really can be very helpful in moving that along.

Chuck Gaidica:
I think change can happen physically as well. Right? We can have, you mentioned puzzles, my wife loves puzzles and gosh, I’ve watched her do so many of them. I sit down every once in a while, it’s not my deal. But just changing up your habit. Instead of sitting down and binge watching three or four episodes of something, changing up and having the board game, changing up and going for the walk, just changing up the routine has tended to bring some health to our lives. And I suspect we’re not alone.

Dr. Amy McKenzie:
No, I think that’s a really great point. Many times we have five or 10 minutes and we sit down and maybe pop our social media account on or turn on the television. But those things actually aren’t for most people, the things that will help restore your mental health or your well-being. It’s really more, some of the things that you’re talking about that are more interactional, right? A puzzle, you can do that with your family. We had set up a puzzle in the middle of our table and we weren’t even all doing it together, but we would step in and each of us do different pieces. And then we would laugh and talk about who figured this piece out. So doing things that help you to engage with others, whether that be through a virtual Zoom where you can see others or with your own family, if you have others living with you, I think is really key.

Chuck Gaidica:
As we start to wrap up here, give us maybe some takeaways, even a recap of what we’ve discussed, because there’s so much rich content, all the things you’ve been talking about. We’ve been talking about emotional work and emotional labor. But what are some of the things that we can still do now, as we’re coming out of this pandemic, for us to find emotional health?

Dr. Amy McKenzie:
Yeah, I think if there was one key thing to leave the audience with, it’s that taking time for yourself and for self-care is not selfish. Even if it’s just five minutes, you start off with a day and you build up over time, carving that time away, it’s really the best gift you can give to yourself and those that you love. Spending time taking a brief walk, connecting with others, doing things that are meaningful in your life that help recharge your batteries is critically important.

Chuck Gaidica:
And thanks to you and all of those working in the healthcare industry and on the frontline for allowing yourself to super impose another level of stress and emotional labor on top of all that you may be doing as a mom and as a spouse. So thank you and all of your colleagues for what you’ve done for all of us during this time.

Dr. Amy McKenzie:
Yeah. Thanks Chuck. We’re all in this together, right? The light is at the end of the tunnel, though. We have vaccinations and we’re all working on getting through this new change together.

Chuck Gaidica:
Well Dr. Amy McKenzie has been with us. She’s the Associate Chief Medical Officer for Provider Engagement with Blue Cross Blue Shield of Michigan. What a joy to connect with you today. Thank you, doctor.

Dr. Amy McKenzie:
Thank you.

Chuck Gaidica:
Thanks for listening to this program, A Healthier Michigan Podcast, brought to you by Blue Cross Blue Shield of Michigan. If you like our show, you want to know more, check us out. You can go online. Here’s the web address, ahealthiermichigan.org/podcast. Great resources there. This podcast episode and all the previous episodes. So you can take us with you wherever you go, whether you’re working out in the house, going for a walk outside. You can leave us reviews or ratings on Apple Podcasts or Stitcher, and you can get great new episodes as well on your smartphone or tablet. Be sure to subscribe to us on Apple Podcasts, Spotify, or your favorite podcast app. I’m Chuck Gaidica, take good care.