Celebrate You: Prioritizing Your Self-Care and Mental Health

Celeste Headlee:
How are you doing? I mean, I wonder because-

Dr. Nina Vasan:
Thank you for asking.

Celeste Headlee:
The people who have to take care of other people’s mental states, I always wonder in times like this when they’re surrounded by people in need, how are you doing?

Dr. Nina Vasan:
As I said, thank you very much for asking. It is true that we probably don’t get asked that as much, and we ask that a lot to pretty much everyone in our lives, right? Not only our patients, but certainly friends and family and it means a lot to receive that question. Overall, I think I am definitely okay. If I think back over the year, there’ve certainly been more highs and lows and more lows than any other time in the last few years for sure. But at the same time, to your point of, as someone who is taking care of those who are struggling and I’m a practicing psychiatrist and I see a range of patients, the majority of my patients are executives and entrepreneurs. But I also see folks from the whole spectrum in terms of socioeconomic background and issues that people are struggling with.

Dr. Nina Vasan:
I have to say that while it definitely is hard when people are struggling, especially on those days where you see that there is either enormous struggle for one or two people, or just kind of this collective low mood that you really feel is kind of permeating most of society. At the same time, one of the things that I find to be the biggest sources of privilege and joy in the profession, is that you do see the best of people come out, you see resilience, you see hope, you see amazing ability to overcome adversity. I think that when I see my patients, I find myself really focusing on that instead, where it helps to give a really positive outlook on life, on what all of us are capable of and of keeping that spirit there, that despite the huge struggles and challenges our entire world has faced this year, that we are resilient, right? We’ve evolved evolutionarily over the last thousands and thousands of years to be strong and that’s what I’m seeing.

Celeste Headlee:
We hear a lot that the holidays are particularly difficult for people from a mental health standpoint. I wonder how that’s different in 2020. It could be that people are not having the added stress of having family over or cooking for a large group of people. But what do you expect in this holiday season when it comes to people’s state of mind?

Dr. Nina Vasan:
That’s a really important question. When we think about the reason why mental health exists, the model that we use is called the biopsychosocial model. What this represents is the three main buckets of what contributes to health being any place along the spectrum that it is, from great to horrible. What that breaks down into is bio, biological, psycho, psychological, and social, which is a mix of social and environmental. If we think about those three areas, biologically, the reason why or one of the reasons why the holidays are especially stressful is around, if we think about something like seasonal affective disorder, the weather changes and that changes the way our brain is reacting and the neurotransmitters that are going through our brains certainly have different biological levels when it’s rainy or when it’s snowing or just that kind of overall sense of what the world looks like.

Dr. Nina Vasan:
From the psychological perspective, one of the hardest things that happens around the holidays, and again, this is the holidays in general, and then I’ll get to what’s going on uniquely this year. When it comes to the holidays, there’s such image out there of the holidays being perfect. When we look at the Hollywood movies and event stories that we grow up with, the holidays are supposed to be this beautiful magical time. The reality, especially this year is that families fight, relationships are hard. You might not get the bonus you’re looking for. I know it’s Stanford, no one’s getting their annual kind of bonus or any kind of even raise period. The expectations and the change and the difference in reality and expectations is highest around the holidays than any other time, because you think and you hope and you’re kind of told by all these external signals and cues that you’re supposed to be happy.

Dr. Nina Vasan:
If you’re not then feeling that way, or if there’s some disappointments like you have an argument with your partner or your parents have different expectations, then all of that ends up really weighing on you because the image you imagine and the image that you might even have been hoping for and looking forward to in September, October, November, it doesn’t actually happen. That disconnect ends up leading to a lot of psychological damage and difficulty. Finally, we have the social, when we think about the social, we think of social, environmental, historical, and a little bit of those areas. What happens there is that you’re having multiple opportunities to feel better. You’re maybe putting up the Christmas tree or caroling or going to a series of holiday parties and that’s kind of what your environment looks like.

Dr. Nina Vasan:
Some of the things that actually end up being especially hard around the environment actually are related to substances. We see a big increase in drinking, in using other substances like marijuana or other recreational drugs. While that ends up maybe having a short term benefit or necessarily, I shouldn’t say benefit, but make someone feel better in the short-term. In the long-term, all of these really end up worsening depression, worsening anxiety. That’s why we realize that the holidays are especially hard for people, and then to get to the second part of your question around, what’s different this year, many things. I think that, well, it depends on who you are and what brings you joy? I’ll give myself as an example. I’m very extroverted and so, I love being able to go to parties and meet new people and reconnect with past friends and everything.

Dr. Nina Vasan:
Even I love throwing parties. Throwing parties is one of my favorite things period, and [inaudible 00:07:38]

Celeste Headlee:
Me too.

Dr. Nina Vasan:
Yeah. To have that taken away or to only be able to do it for one or two people instead of 10, 20, 50, 100 people. For me, that was always one source of joy and something I really looked forward to and that’s been taken away, right? For everyone now across the country, across the world, things that normally had helped us stay resilient or when times were tough over the holidays, the ways over the years that we’ve learned to cope, have been taken away. Whether that’s going to a movie by yourself and watching something that makes you feel happy through these parties. I’ll wrap it up with one thought, which is around hope.

Dr. Nina Vasan:
One of the things that I think the holidays are just so classic for, is the sense of hope, and hope ends up being really, really important. We actually see that the brain changes in terms of the brain chemistry and when people are hopeful, endorphins get produced. That ends up leading to an improved sense of wellbeing and overall, people end up being more calm, more open and everything. This year in particular, I think for a lot of people, they felt both a sense of decreased hope, as well as just chronic uncertainty in a way that we’ve never had to experience before. Those two things in combination, it’s almost like the things that were positive have been kind of temporarily removed and then we’ve had all these added kind of negative stressors, which has made it very, very hard.

Celeste Headlee:
Over the past year, I’m sure you have watched the decline in mental health measures on a broad scale. I wonder if that also concerns you at least a little for the holidays, because I’m sure that many people are either not going to therapy because they have lost their job. Maybe they’ve lost their healthcare. Maybe they have reservations about seeing a therapist and maybe it’s just that they don’t want to use Zoom and in-person appointments aren’t available, and so you have sort of a bad combination of mental health measures declining and people not seeking help. What kind of advice can you give people on how to take care of themselves?

Dr. Nina Vasan:
Yeah. Well, first of all, you’re absolutely right. I’m very, very concerned about what’s going on right now. We’re seeing rates almost double across the board and especially in racial minority communities in particular, the Black and African-American communities as well as, in some cases the Latinx communities and Asian communities. We’re seeing even higher three X increase in certain conditions and certainly this overlap with what we’ve experienced this year around systemic racism and brutality and everything. It’s very concerning just seeing these unprecedented rates. At the same time, what I actually would say is, while there are absolutely folks who have lost their health insurance and who are not seeking care, what I actually have seen for an overall trend is, one of the silver linings actually, that myself and others in the field have talked about this year is that, we’ve seen a huge acceleration in stigma decreasing.

Dr. Nina Vasan:
I can give this example that I start my day with the New York Times and before coronavirus, there would probably be an article on anxiety or stress or some mental health issue on the front page maybe once a week but probably not even that, versus now, it’s really almost every single day that I see something, whether it might be the parenting section or the wealth section or even just overall health science society. That people are talking about struggling with mental health at levels that they never were before, and not just general kind of broader society but people who are influencers, right? Everything from celebrities to politicians and when these messages are then getting out there that much more, what I’m pleasantly surprised to see is, people being a lot more willing to say, “I’m struggling. I’m having a hard time,” and taking that next step of, “I think I need to get help.”

Dr. Nina Vasan:
I think that right now, what help has looked like for a lot of people is just talking about it, which is a really, really important first step. I hope that what can happen in the coming months is really getting kind of the serious professional care, that is so important. I think everything that you brought up around, if the financial resources are lower or people have Zoom fatigue, and there are a whole hosts of reasons why people may not seek help. What I do think I’ve seen is those who already had sought out help seem to be actually doing a good job of staying consistent. In fact, one of the statistics I’ve been sharing with people is that, in my own practice at Stanford, I have both a practice at Stanford and a private practice.

Dr. Nina Vasan:
My private practice rates are usually great. People would come almost all the time, but at Stanford, the no-show rate used to be anywhere from maybe 10, 20%. I’m in Sunny Palo Alto and so sometimes when it was raining or things like that, it would be even lower as people were less likely to leave or be outside. But since coronavirus started, I’ve really had almost a 99, 100% attendance rate. To me, that’s a really good sign that, as I said, people who are already engaged in the system seem to be doing a good job of continuing. But how do we get people who have never been a part of the healthcare system? How do we help them get care? We can talk about that in a little bit.

Celeste Headlee:
Well, we might as well just talk about it now. I wanted to start by talking about the things that perhaps people do that make it worse. In other words, a friend of mine, a neighbor of mine has been to the doctor several times for sleep disruption. She’s extremely stressed out. She’s not sleeping well, and because she’s in this state of stress, she’s doomscrolling. She’s constantly checking her social media feeds, which is only raising her stress levels. As her stress levels raise, that makes her more afraid, makes her feel more dread and then what does that do? It pushes her to doomscroll more. What advice do you have for people who may be caught in that kind of vicious cycle of their fear pushing them toward habits that in the end are not going to improve their mental health or their wellbeing?

Dr. Nina Vasan:
Yeah. That’s so important. There are a few words that are certainly becoming the words of 2020. I think that unfortunately, doomscrolling is absolutely one of them. It’s so [inaudible 00:14:47] especially before falling asleep. It’s this cycle of, “I can’t fall asleep, so I need to something to do. Let me get my phone,” and so not only are those lights on, and I mentioned earlier about the biological, psychological and social. The lights being on makes it harder to fall asleep then what you’re reading triggers all these emotions or thoughts that make it hard to fall asleep and then, the addiction of keeping scrolling and doing more and more. All of these just exacerbated and really put you on a downward spiral.

Dr. Nina Vasan:
That’s one thing that I’ve certainly seen, and actually just to go back in terms of the problems. What we’ve especially seen is two X increases if not more. I would say the biggest things I’ve seen, depression, anxiety, substance use. When we think about symptoms, symptoms of trauma, both where folks had past traumas that have now kind of come back to the surface, as well as this almost like collective societal level trauma that we’re facing. Then finally, the one symptom I’ve seen that just seems to have become the highest rates I’ve ever seen before, is specifically insomnia. That’s difficulty falling asleep, staying asleep or early morning awakening. The good thing, I’ll actually just start with insomnia because this is, I think what your friend is struggling with. Usually there’s a big link between insomnia and anxiety.

Dr. Nina Vasan:
They kind of end up being cyclical. But one of the best things about insomnia is actually, there are a whole host of things that people can do to help. I’ll go back to that biopsychosocial model because that’s really how we think about not only why you’re struggling, but also how to get better. Biologically, melatonin is something that you can buy over the counter and one of the safest medications we have out there, and taking a little melatonin before falling asleep can make a big difference in helping you kind of calm down.

Dr. Nina Vasan:
Why I really like sleep as a problem is because there are so many behavioral changes that people can make. Everything taking a bath or a shower before falling asleep and what we see is the change in temperature ends up leading to the body kind of starting to shut down. Candles like lavender and jasmine that are calming and help you fall asleep. Journaling, especially I think when you’re having anxiety, journaling ends up being an incredibly helpful tool because then instead of ruminating and having these thoughts going in spirals in your mind, you’re actually able to write them down and process them a little bit better.

Dr. Nina Vasan:
What that comes to is that, kind of the last thing I’ll say about that is just, being a lot more aware of what you’re dealing with and why. That awareness which you can get through something like mindfulness meditation. You can get that through journaling or even something like prayer, ends up being one of the best things you can do because it’s really just you being in tune with yourself and understanding more about the thoughts and emotions you’re experiencing. I would definitely recommend that to everyone. I think that’s tremendously important. To the other issues just in terms of the things that, especially on the holidays, end up being highest yield. Substances are something, especially if we think of something like alcohol, there are a lot of jokes certainly.

Dr. Nina Vasan:
I mean, the things since quarantine started, the quarantini and all those sorts of things are out. People kind of jokingly and seriously talking about how they’re drinking more or maybe, I’m in California, so there are a lot of people who are using different cannabis products a lot more. The concern there is that people who do have an addiction, the holidays end up being especially difficult because in a lot of ways, we make it socially okay to be using and to be using at levels that aren’t really quite healthy, as well as then for people who might not have got an addiction issue, still that overuse can end up being pretty toxic.

Dr. Nina Vasan:
As I said, in the long run end up not helping, even if we take something like alcohol. Initially alcohol makes you sleepy, but as it breaks down over a couple hours, then it actually ends up being almost more like a stimulant. You end up actually having very poor quality of sleep because you’re not entering those deep sleep phases. A lot of people drink right before going to bed, right? Or most people are drinking in the evenings and so it’s kind of the worst time actually to be doing that when we think about something like sleep.

Celeste Headlee:
I wanted to go through some of the other things that people can do and maybe I should phrase them in the things that they’re doing that are not helpful because I’m seeing this all around me right now. For example, a number of my friends are very stressed out right now, very anxious, very worried [inaudible 00:19:44] right? They’re turning down phone calls. They’re only texting or emailing. Also, I’m seeing some horrible eating habits. I’ve seen people’s exercise routines fall straight into the trash bin. There are two things here, right? There’s the things that people are doing that are possibly making their wellbeing go down, and perhaps there’s another column of things that they could be doing to increase well-being. Could you go through some of those things?

Dr. Nina Vasan:
Yeah. Absolutely. I think you’re right that it’s the same topics end up being both the things that help you get a lot better as well as, all of these topics which I’ll review. They are all behaviors and even if we just think of something like exercise, right? Yes, exercise, if you were to ask me what are the three best things, I would say, exercise, sleep and mindfulness. What that comes down to is that, these are the things that we have the absolute best scientific evidence for, as being incredibly helpful from head to toe really. Moreover, no matter who you are, whether you’re severely depressed or you’re just a smidge socially anxious at times, these are the things that really help everyone across the board to get better.

Dr. Nina Vasan:
When you’re doing it, that’s great, and then exactly as you’re saying. When you’re not doing it or when it was a part of your life and you’ve kind of given up on those things, it really does end up taking a toll. The areas that I think are most important, as I said, exercise would certainly be number one in this setting. In fact, when people are talking about why they’re so stressed this year or what’s been hard this year, I suppose maybe almost pleasantly surprised at how many people say, not being able to go to my gym. I’m here in Silicon Valley and there are a lot of Frisbee players at the tech companies. I’ve heard a number of people talking about how their Ultimate Frisbee League is no longer in play and that’s something that they really miss out on. When it comes to exercise, there’s both the actual physical part of exercise, but also for a lot of people, it’s socializing, right?

Dr. Nina Vasan:
It’s like maybe you do SoulCycle with a couple of friends and that’s one of your top social events of the week. Losing that and now having to either exercise at home or do Zoom videos or maybe it’s being able to jog around the neighborhood. Those are so important. As I said, these single best, the only silver bullet, if you will, I think that we probably have in the field of healthcare is exercise. Number two, I’ll jump into is mindfulness meditation, where I recommend apps like Calm and Headspace to people because they make it really easy to do mindfulness meditation. It’s really remarkable how helpful that ends up being. Sleep is going to be number three and I think that exactly, as you were saying that, with things like doomscrolling it’s become really hard to prioritize sleep.

Dr. Nina Vasan:
One of the things I recommend to people is, if you Google sleep hygiene. Just sleep hygiene pretty much, you’ll get a load of tips, everything from decreasing the temperature of your bedroom to high 60s to low 70s, or having blackout shades or earplugs, and little really simple things like that, that actually end up making a really big difference for a lot of people in being able to sleep better. That’s another thing I would mention. You talked about nutrition. Nutrition is actually still under appreciated facets that contribute phenomenally to our overall wellbeing in health on a daily level as well as of course, on the big picture scale. Yeah. I mean, I’ve certainly been in line with CVS or even Whole Foods where things are supposed to be healthy and seeing the increase in process food [crosstalk 00:00:23:45].

Celeste Headlee:
The entire [crosstalk 00:23:45] full of barbecue [inaudible 00:23:46]

Dr. Nina Vasan:
Yes. Exactly. I’ll [inaudible 00:23:49] myself. I love Williams Sonoma peppermint bark and now is the exact time that it’s been released and so, I totally saw yesterday like, “Ooh, it’s [inaudible 00:23:59] so maybe I should buy more of it.” There’s definitely an emotional eating component too to that peppermint bark and bringing happiness. Anyway, I just wanted to point out tips. I think tips are so helpful. We talked about mindfulness, sleep, nutrition, substances, exercise. One of the things I think actually, that’s the best about the holidays is gratitude. Similarly, enormous evidence about how just a simple gratitude practice like writing down two things you’re grateful for everyday, can go so far. Everything from improving depression and anxiety, but also improving productivity. There’s amazing research that shows, I think it’s even when teachers do gratitude journaling, that their students end up with higher test scores.

Dr. Nina Vasan:
I think given so much of the holidays is around everything from, Thanksgiving, Christmas, new years. It really gives a good opportunity to be grateful and also giving. I think giving is especially valuable, that could be giving gifts, that could be giving time or donations or even just random acts of kindness like being in the grocery store and when you check out, maybe you buy a gift card and give it to the grocery store clerk and things like that to help people see that you appreciate them. Those random acts of kindness, those little small things that are very easy actually for all of us to do, but speak volumes. I think those can really make people feel a lot better.

Celeste Headlee:
What can we do if someone we know and care about is struggling? What’s the best way to help someone else?

Dr. Nina Vasan:
Yeah. I’d actually love to ask you, in your own experience, what have you seen to be helpful?

Celeste Headlee:
I ask them what they’d need and I say, “Listen, I’m not asking you rhetorically. Do you want to come over for dinner? Can I clean your house for you?” That’s basically what I’ve been doing. I put up a little food pantry outside my house, a little free food pantry. I mean, just those little things.

Dr. Nina Vasan:
First, I love that. That’s absolutely phenomenal. That is the exact answer. You nailed it. It really is asking people and part of it is, not everyone has insight into what they need, but a lot of people do. Moreover, for example, assuming that they want to problem solve what’s going on. It might just be, they just need someone to listen, right? Or that they recognize they’ve kind of hit a level that’s lower than they ever had before, maybe they actually need someone to hold their hand as they seek professional help. Asking is definitely the single best first thing to do and really listening, right? Whether that’s listening to what they’re saying or just being there to hear what’s going on. Now, the first thing you asked me was how am I, and especially as someone who is hearing mental health kind of struggles and challenges on a daily basis, it’s important for you as an individual to make sure to put your own self-care, to prioritize that, right?

Dr. Nina Vasan:
To make sure that as you are hearing about friends and family and loved ones, their struggles, that it’s not getting you down because you’re just like we sort of say that in the plane, you put the mask on yourself first, right? Because you have to take care of yourself first before you can take care of others. I think that’s definitely important. But one of the things, back to the question of, how do you help your loved one. Asking first, absolutely, listening and then in the most, I think de-stigmatizing way possible, being able to really help talk through, especially if you’re worried. One of the first things that we do as professionals is what we would call triage. We try to figure out, is this person, even if we think of the spectrum from illness to wellness. Where on the spectrum do they lie and what is the urgency with which they need to get help?

Dr. Nina Vasan:
In particular, if someone is really low, it looks like they’re at one of the lowest points that you’ve seen or that they’ve been and or you hear things that really concern you for their safety, for their health. That’s when it’s really important to act urgently and do so in a way that’s supportive. The final thing I’ll add to that is, what I’ve seen actually over the last few years, especially within families is, a lot of times mental health doesn’t get talked about in families, and being able to share one’s own experience, whether that is with kind of a diagnosed mental health condition or even just if it’s, I get really anxious before my quarterly reviews at work or something. But being able to talk about it and to share one’s own vulnerabilities end up I think going a long way to then make whoever you’re talking to feel safe, to share on a deeper level.

Dr. Nina Vasan:
I do think self-disclosure is something that everyone has their own level. I, myself talk very openly about my own struggles with depression and anxiety, and that’s something I’ve specifically chosen to do and not everyone wants to do that, and certainly it’s important for everyone to do what’s right for them in their own comfort levels. But I do think that even in my own experience, the feedback and reception that I’ve gotten is that when I disclose myself, the depth of conversation will end up getting a lot deeper, a lot quicker, I think, because that sense of safety is there.

Celeste Headlee:
Before you go, for my last question, I wanted to give you a chance to talk about Real. I wanted to end here mostly because it seems like a good gift to give someone if you have that kind of relationship with them. I mean, I’m just thinking about all of the harried, fraught, anxious people around me.

Dr. Nina Vasan:
Yes.

Celeste Headlee:
Can you tell me what Real does and why you’ve launched it?

Dr. Nina Vasan:
Yeah. Absolutely. I would love to, and it’s funny you mentioned that because literally I think just a couple of days ago, we did launch a Give the Gift of Mental Health basically like a gift card sort of offering.

Celeste Headlee:
That’s a good idea.

Dr. Nina Vasan:
It’s definitely tricky. I can see a lot of memes or things on Instagram that are making fun of like, “I’m giving you mental health services,” but very seriously. We’ve created gift cards that allow you to give anywhere I think from one month to six months of membership into Real. For those who don’t know, Real is a new digital on-demand mental health, kind of both service and community and I can kind of talk through what that means.

Dr. Nina Vasan:
Let me go back to actually explain. When it comes to mental health and mental health services, there’s certainly a wide range of digital products out there. There are things like Talkspace or BetterHelp or different apps and all of that, are offering different things. The reason why we realized that we need to be able to offer something different is that, one is quality. The quality of a lot of, especially the more affordable things out there is just not very high or consistent. What people end up feeling is like, “Oh, maybe I could have just asked my friend this. Is this actually scientifically evidence-based? Am I actually getting the best data and kind of scientific understanding of what’s out there to help me get better?”

Dr. Nina Vasan:
The reality is, a lot of kind of more affordable options out there, the quality is just not that high. The second thing though is access, which is that one of the biggest hurdles in mental health care is, going to your doctor once a week or once a month. Pre coronavirus probably taking two or three hours out of your day in order to make that appointment and so, the issue of access, I think both it comes down to cost of being able to offer something really low cost and Real is actually less than $1 a day, which is the least expensive or most affordable mental health service that certainly I’ve ever seen. Definitely when you think of the kind of cost of therapy, therapy sessions can range from 100 to 400, $500 in certain areas like New York.

Dr. Nina Vasan:
Literally for what you might pay for one session, you can end up getting six months of care. Access as I said, one is cost and two is just convenience, right? Which is if you’re having an appointment at 2:00 PM every Thursday and you’re a working mom, it’s very difficult to make that appointment. One of the first things that we wanted to be able to do with Real is, kind of choose your own adventure not only what you engage in, but being able to do it on your own time. There are three main offerings that we have. The first and kind of primary is what we call Pathways. What that is, is its anywhere from a six to 12 week program. Almost like a course on a specific area of mental health.

Dr. Nina Vasan:
That could be anything from anxiety or depression to something like sexuality or one of the most successful groups that we’ve just had is specifically a career-based pathway for women of color. What you’ll hear is, there’s that specificity, that’s being able to choose a specific problem that you know you’re dealing with, and then being able to engage with curriculum created by a therapist that allows you to learn both the kind of theoretical as well as the practical steps to get better, as well as do things like reflection exercises, so that you can really apply it to your own life. What’s been actually amazing is we’ve already seen very kind of statistically significant and clinically significant improvements in people’s health in just a very short amount of time, which I think it’s certainly showing that things are working. People are going from being moderately or severely anxious to being normal by engaging in one of these.

Dr. Nina Vasan:
That’s been really promising. The other two things. One is what we call a Salon Series, which is kind of like a group therapy, essentially around particular topics where you then, community and connection I think are one of the most important elements of overall mental health and wellbeing, especially at this time of coronavirus and quarantine. That has ended up to be a really wonderful offering for folks, as well as we have kind of open events where people can even bring a friend and just talk about a lot of topics. I’ve been speaking with people around medication or topics like ADHD or seasonal affective disorder. We had election town halls for people who are struggling with election anxiety as well as, how do I talk to my parents when they have a completely different political affiliation from me and things like that.

Dr. Nina Vasan:
What’s been great about it is, as I said, one is this super low cost. Which I think just allows you to test it out in a way that it’s hard sometimes to even test out a session of therapy, as well as the convenience of doing it on your own time. But then finally, I think it just goes down to quality and offering things where we know scientifically these work for most people and delivering it in a way that’s really easy to access.

Celeste Headlee:
Okay. Well, I mean, I think it looks good as a gift and I may end up giving it to my neighbor who can’t sleep. I mean, I think I wish everyone better improved wellbeing, not just through the holidays, but next year as well. I want to thank you so much. I mean, very, very practical advice here. Thank you so much for joining us and sharing your wisdom on better mental health but also just better lives.

Dr. Nina Vasan:
Oh, good. I’m so glad. Thank you. Thank you so much for having me. I really appreciate you covering this topic. I really have had a number of patients who were talking about struggling around the holidays. I think being able to listen to this and realize that this is something that so many folks are dealing with, will really help people get better.