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Do unto yourself.

Your daughter expects you to pick her up from school at four o’clock. When it’s almost time to leave, you decide, ‘I don’t feel like it today’. It’s been a busy week with a lot going on. You grab some food and scroll through your social media feed and don’t show up. Your close friend asks you to bring her a few essential things after she is unexpectedly admitted to hospital with a serious illness. You stay up later than you had planned, binge watching your favourite show on Netflix. When your alarm goes off so that you can stop by the hospital before work, you hit snooze and decide you will do it another time.

Do these scenarios sound ridiculous? Of course you would pick up your daughter (or at least make other appropriate arrangements). Would you blow off helping your sick friend? I doubt it. We would never treat somebody that way. Except ourselves.

We treat ourselves this way all the time. You plan to exercise after work. You might even pack everything you need. But the day is long and hard. Stressful things happen. When the time comes, you decide you’ll do it when you’re less overwhelmed. You grab some food and scroll through social media instead. You make a grocery list of reasonable foods with the intention of prepping them for the week. But you stay up later than you expect, feel tired and too pressed for time. You head to the drive thru instead and eat Combo #2 in front of the tv. Do these things sound as shocking? No. They sound like daily occurrences for many of us. They are actually THE SAME THING.

Imagine if you showed up for yourself the way you do for other people? You would make promises to yourself and follow through with them. You would do things that you don’t feel like doing because you know you need to. We do the easier thing because it feels good in the moment. A small hit of dopamine from the cookie, the Instagram scroll, a bigger dopamine hit from the soda, the glass of wine, the online purchase. Our brain bathes in this ‘reward chemical’ and learns that these behaviours feel good, making us want to do them again. Especially when we feel depleted, tired, and overwhelmed. This is normal, right? Human nature. What if this was actually completely within our control?

We can manage our minds so that we don’t feel depleted, emotionally exhausted and stuck in overwhelm. This is what cognitive behavioural therapy (CBT), an evidence based treatment for depression and anxiety, is all about – understanding that our thoughts create our emotions and behaviours and that those thoughts can be changed by working at it. If you’re not up for a full course of CBT just yet, try thinking – ‘What if I showed up for myself the way I do for other people?’ The more you do it – the things that are hard or don’t give you that dopamine hit right away, the better you feel. The better you feel, the less you need that dopamine hit. Next time you consider working out tomorrow, imagine your friend invited you and is waiting for you. Don’t stand her up, she deserves nothing but the best.

– Guest contributor, Dr. Mary Preisman 



Assistant Professor, University of Toronto Department of Psychiatry

Dr. Preisman is a consultation liaison psychiatrist at Mount Sinai Hospital. Her areas of clinical focus and expertise include critical care psychiatry and inpatient perinatal psychiatry. She is very involved in medical education as the PGY1 Coordinator for the Department of Psychiatry, the course director of the University of Toronto Psychiatry Refresher Course and as an inter-specialty educator in collaboration with family medicine, internal medicine, critical care and obstetrics. She is passionate about work-life integration and runs a wellness series for ICU fellow as well as a busy household with two young children.

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