Program: Mental health: Anxiety and how to beat it

Tamar
Hello ladies. Just before we start, a heads up that this episode contains some heavy content and there's mention of suicide. Know that help is always available and we'll leave some resources in the show notes if you need them.

Bronwyn
Anxiety is a hugely physical condition because when we feel anxious our brains are saying there is a threat and I need to deal with this.

Julia
I could just feel it start in my stomach, the twisting and the nodding, then I felt it creep up to my chest and I couldn't breathe. I could feel it just flush straight to my face.

Julie
I'd be in the office with my head on the desk just hyperventilating and just thinking I've got to go out and I mean I've got to go out.

Bronwyn
We have such a good understanding of why anxiety exists because it's part of our evolutionary history and we know what we need to do to treat it.

Yumi
If you're a regular listener to Ladies We Need To Talk you'll know that we've talked about anxiety before on the show. In the years since, life hasn't got any less anxious making. In fact, anxiety is the most common mental health issue facing women in Australia. According to the latest National Study of Mental Health and Well-Being, one in three women will be diagnosed with an anxiety disorder in her lifetime. In our first episode in this mental health mini series, we looked at depression in women. If you haven't listened yet, check it out. And the thing about depression and anxiety is that they often go together like fish and chips, bluey and bingo or cigarettes and alcohol.

Yumi
And look, it's easy to understand why we're feeling anxious. The world seems to be hurtling towards a moral, systems and environmental collapse. It is the most anguishing timeline and self-soothing through food or fun just got impossibly expensive. Meanwhile, women are still expected to carry an obnoxiously imbalanced domestic and mental load. Anxiety, let's be honest, seems like an appropriate response right now. But there are things we can do to tackle our anxiety. Guardrails we can put in place to fortify ourselves against its disturbances.

Yumi
I'm Yumi Stynes. Ladies, we need to talk about facing anxiety head on. A lot of us fell in love with Julie Goodwin back in 2009, when this bubbly, relatable mum of three made it all the way to the final of the TV juggernaut MasterChef. To look at her on screen during that final, everything seemed great. She was smiling while she ran around whisking and searing and basting. But underneath, Julie was in turmoil.

Julie
And I remember saying it to Po, I feel like I'm underwater. I can't quite hear anything properly. And I can't quite breathe properly. And I literally felt like I was in a taintful of water.

Yumi
What Julie didn't realise was that she was having an extreme anxiety response.

Julie
I think that that MasterChef experience played into my perfectionism more than anything I've ever had.

Yumi
From her youngest days, Julie remembers feeling anxious and that she needed to be perfect.

Julie
My father left when I was three, almost four. And you internalise that even as a toddler. How I'd made myself as lovable as I could make myself. And that made me as safe as I could make myself. You know, no one will leave me if I'm this shiny, high achieving little person.

Yumi
The anxious feelings and the need to be seen as perfect continued for Julie as a mum in her mid-twenties with three kids under three.

Julie
I'd hang their little singlets on the clothesline in size order. And then I had to make sure that the pegs matched the colours of the clothing. And there was some kind of fear that someone was going to land on my doorstep and judge me on whether or not the cot sheets were ironed or their little pillowcases were ironed or whether the towels were all folded with the selvedges at one end and, you know, placed properly in the linen closet. And that the taps had been scrubbed with a toothbrush. And there was, it was a lot.

Yumi
Fast forward to when her boys were teenagers and Julie had one MasterChef. Life ramped up to hitherto unimaginably manic levels. She was co-hosting a breakfast radio show and writing for magazines. Oh, and running her own cooking school.

Julie
I had to be here, there and everywhere, every day. All this stuff, you know, it was relentless. And my poor family, there were no slots in there for them. There was nothing in there for self-care.

Yumi
Can you describe that feeling that you had when you used to knock off your radio shift doing breakfast radio, which is brutal in the best of circumstances, and getting in your car and feeling your face surrender that tight smile that you'd been having all morning?

Julie
I'll never forget because, bloody radio, you can't have an off day. You can't go in and go, I'm having a bit of a blue day, so just leave me alone for a minute. You gotta be on, on, on, on. And so some days I would leave the radio station, I would physically feel my face like a mask stuck in this position. And I would have to try and release those muscles to let it come down. And there were days where I just could not face another human being, you know. And I'd have to go off and be by myself. And some of those days were extremely dark.

Yumi
After years of these acute feelings of panic and anxiety, Julie sought help from a doctor. She was diagnosed with both anxiety and depression, and she was put on antidepressant medication.

Julie
And it worked for six months and then it stopped like, like I hit a wall.

Yumi
Can you talk us through how your anxiety and your depression was affecting you physically, day to day? What was going on with your body?

Julie
So much. My brain must have just gone, you are not paying attention to the symptoms and the signs that I am sending you. So I'm going to send you some newies. And they came out in all these different physical ways where I thought I had a series of different illnesses, but really it was all the one illness. It was all mental illness. But it was coming out. I would get sores on my head, like scabs on my head, cold sores. At one point I broke out in boils, like boils all over my body. I got the shakes. I was shaking so badly that I couldn't hold cutlery. I would go to eat and it would be like a palsy. I went through a period of dizzy spells where I would just drop into a faint, you know. And all of these things have since been traced back to the symptoms of anxiety.

Bronwyn
Our brains are saying there is a threat and I need to deal with this.

Yumi
Ladies, this is Professor Bronwyn Graham, behavioural neuroscientist and clinical psychologist at the University of New South Wales and the George Institute for Global Health and new friend of the podcast. You heard Bronwyn in the first episode in this series on depression. If you haven't listened yet, you can go back after this. She says there's no living life as a human without experiencing anxiety.

Bronwyn
Humans are actually really good at it. It's the thing that from an evolutionary perspective has protected us for centuries because we're so good at identifying potential threats and then mobilising our fight or flight response and dealing with them.

Yumi
But having an anxiety disorder, that's when your threat response goes into overdrive.

Bronwyn
The difference between experiencing anxiety that is normal and proportionate to the daily stresses that you might be experiencing is the chronicity and the frequency that you're experiencing anxiety, the ease with which you can control it and then the impact that it has on your life.

Yumi
When we say anxiety disorders, what does that encompass?

Bronwyn
It's an umbrella term. So anxiety disorders are a bunch of different disorders. Most commonly social anxiety disorder, specific phobias, generalised anxiety disorder and panic disorder. Panic disorder. Oh gosh. Common to all anxiety disorders is this excessive fear or anxiety about particular cues or situations or excessive worry that is really difficult to control.

Yumi
In the game of anxiety poker, women have a royal flush.

Bronwyn
In women, one in three will experience an anxiety disorder across the lifespan.

Yumi
That's a lot. It's a huge amount. Do we know why there's a higher prevalence in women than in men of anxiety?

Bronwyn
So anxiety and stress go hand in hand. We know that women experience greater levels of stress than men. They also experience particular types of stresses that are much more associated with the development of an anxiety disorder like sexual assault and rape. We know that women carry a greater domestic burden than men. And I think that the increase in anxiety disorders that was disproportionate in women during COVID was directly attributable to the known fact that women were carrying the greater domestic burden during that time.

Yumi
The mental load. There you are again. Seriously, can someone start a Ladies We Need To Talk bingo card? It's not just the patriarchy that's making us anxious though. There are some pretty interesting things going on with our hormones as well.

Bronwyn
Prior to puberty, the rates of anxiety are fairly similar between boys and girls. And it's post-puberty where we see this onset of sex differences in anxiety disorders.

Yumi
Some women with anxiety will experience changes in the severity of their anxiety across the menstrual cycle.

Bronwyn
When they have high levels of sex hormones, their symptoms actually get better. But when they have declining levels of sex hormones, their symptoms flare up. And that's because we need sex hormones to regulate our emotions and particularly to regulate our anxiety and our fear. So we're often blaming sex hormones for women's greater risk of mental illness. Actually, it's a good thing.

Yumi
OK, so declining sex hormones puts you at greater risk for anxiety. Is that likely to strike during perimenopause? Absolutely.

Bronwyn
Perimenopause and the perinatal period as well, which is a time where we do see this increase in first onset anxiety disorders or flare ups of pre-existing anxiety disorders.

Yumi
What is the link between depression and anxiety?

Bronwyn
So they are like brother and sister. OK. Yeah. They're really comorbid, which means that very frequently a person who is depressed may also have some symptoms of anxiety or may actually have an anxiety disorder in its own right.

Yumi
Just like our friend, Julie Goodwin.

Bronwyn
So why do they overlap? There's probably a common genetic basis for depression and anxiety. Genetic studies haven't been able to isolate specific genetic risk factors for anxiety or depression. So it's probably this shared common vulnerability. And a lot of the thought processes that are involved in depression are common to anxiety as well. So this process that we call repetitive negative thinking.

Yumi
We all sometimes have negative thoughts, but when these thoughts are repetitive and relentless, as though your brain is stuck in a groove and can't actually problem solve because it's looping around and around, that manifests as worry in anxiety and rumination in depression.

Bronwyn
And so while rumination is focused on the past and things that you've experienced in the past and symptoms that you've experienced in the past, worry is focused on the future. The underlying process of thinking is the same.

Yumi
Right. I've never heard it so clearly explained. Thank you. That's really, really helpful. Worry versus rumination. What are some of the physical manifestations of anxiety?

Bronwyn
Anxiety is a hugely physical condition because when we feel anxious, what's happening is our brains are saying there is a threat and I need to deal with this. And that tricks off our fight or flight response, which is our body's way of dealing with the threat. And our body has not yet learned to differentiate between threats that are physical in nature where we actually need to fight something or run away, or even threats that are imagined. So just thinking about something bad happening is enough for our bodies to say, okay, I need to be ready. What does ready mean? It's a physical thing. It's our blood rushing to our muscles to mobilize them. It's our gastrointestinal system shutting down because we don't want to be wasting energy on digestion or saliva production. So our mouths are going to go dry. It's our heart racing so that we have the blood pumping around. And it's this laser-like focus on the threat, which means that we're not paying attention to anything else around us, which can have a sort of very strange kind of derealization feeling.

Yumi
Derealization feeling?

Bronwyn
Yes.

Yumi
I've never heard that before.

Bronwyn
Yes.

Bronwyn
So it's kind of like an out-of-body experience.

Yumi
And that's why your mouth goes dry.

Bronwyn
Yes.

Yumi
Oh my God. So many revelations in one episode. That's amazing. And what about when someone is having a full-blown panic attack?

Bronwyn
A full-blown panic attack is really just a lot of those symptoms all at once.

Julia
I could just feel it start in my stomach, the twisting and the nodding. Then I felt it creep up to my chest and I couldn't breathe. I could feel it just flush straight to my face.

Yumi
I want to introduce you to Julia, a ramen-loving event planner from a small coastal town in New South Wales. And yes, we are speaking to Julie and Julia for this episode. And yes, one of them is a cook. Julia is 37 and has been having panic attacks since she was little. Recently, she was at a multi-day training course for work when her body went into a state of panic.

Julia
And I knew that I was going to cry. And I don't really know any of those people either. So I just kind of went out, went to the bathroom and then went and sat down outside by myself. Like I had to just focus on breathing because I couldn't breathe. Well, that would be terrifying. It's pretty terrifying. Yeah, exactly. And so then that kind of exacerbates it all. And I get severe IBS as well. So then your tummy's churning, which is then linked to everything else. So then you're worried you're going to shit yourself. Like it's just there's a whole series of events that could or could not happen. So you just play it by ear.

Yumi
Julia's not sure why she had the panic attack during the course that day. She was out of her comfort zone for sure with a bunch of people she didn't know. And a sense of being out of control can set her anxiety off. But her anxiety is a tricky, unpredictable beast.

Julia
I might not even notice it one day and then another day I might go to the shops and go to buy a specific item and I'll stand like in the bread aisle or whatever for 45 minutes. Like it's debilitating. You just cannot make the decision on what you want to buy or what bread you want to pick. And in the end, I don't even want bread, you know.

Yumi
In her 20s, Julia started getting professional help for her anxiety, as well as ticking the boxes for generalised anxiety disorder. Julia was diagnosed with insomnia and obsessive compulsive disorder. The doctors recommended Julia start on antidepressant medication. She wasn't keen.

Julia
I'd seen at school girls that had been diagnosed with depression and so they went on medication and then they just put on so much weight. And I was so then anxious about that happening to me and what people would perceive or think. Or what if I couldn't lose it again? Or and they'd like they would say, oh, you know, it's only if you eat more or the highs will be just a little less high and your lows will be a little less low. But I was like, I'd rather feel that and be able to try and monitor it myself than lose control of that altogether.

Yumi
So a lot of what sets you off seems to be the sense of losing control.

Julia
Yeah, I think so. I used to suffer from really bad social anxiety. And I would stay awake thinking about, oh, do you think this person thought this when I said that? Or do you think they thought this about me when I did this?

Yumi
A few years ago, Julia and her partner moved to a coastal town and her social anxiety was on full alert as they tried to make new friends and put down roots in a new community. It was a tough time for Julia, but she's now in a place where the volume on her social anxiety has turned right down.

Julia
Just general anxiety is my biggest thing now, so I managed to get rid of that social anxiety. You don't know when it's going to play out or when it's going to pop up, but it's always there. Just you don't know when.

Bronwyn
I love anxiety.

Yumi
This is Professor Bronwyn again, clinical psychologist and anxiety nerd.

Bronwyn
We have such a good understanding of why anxiety exists. I think it's the mental health condition that has the best outcome because it's part of our evolutionary history. And we know what we need to do to treat it. So the first line psychological treatment for anxiety is cognitive behavioural therapy with exposure therapy.

Yumi
Exposure therapy for people with anxiety means helping them face the things that they're afraid of without running away from them.

Bronwyn
So exposure therapy is all about cutting out that avoidance so that the person can learn this thing that I'm afraid of, it doesn't actually happen. Or if it does happen, it's actually not as bad as I thought it would be and I can cope with it. And so what happens is that the person will work with the psychologist to set up a series of challenges where they engage in approaching the things that they've been avoiding and staying in that situation until they can learn from it.

Yumi
Wow. So it's kind of eating shit. Yeah. Isn't it? That you've been trying to avoid your whole life. Yeah. Okay. So we've got psychological interventions. What about medications?

Bronwyn
So antidepressants are misfortunately named. They were marketed for depression, but they're actually just as effective for anxiety. And so that includes selective serotonin reuptake inhibitors or the dual action antidepressants that work on both serotonin and norepinephrine. But those antidepressants are recommended to be taken in combination with some form of exposure therapy.

Yumi
Antidepressants help with anxiety symptoms. But Bronwyn says that if you're still avoiding that thing that's making your lizard brain want to run and hide under a rock, you're not going to conquer your fear.

Bronwyn
If we don't deal with that avoidance, the anxiety will just keep coming back. One thing that people can do to help them avoid the scary situations is that they might take a drug called the benzodiazepine, which most people would know as Valium. They're basically a sedative. So yes, they work. They mask the symptoms because it's really hard to feel anxious if you're sedated. But they have high potential for abuse. And we know that when you're not on them, the anxiety just comes back. And worse than that, we know that if you're taking a benzodiazepine when you're undergoing exposure therapy, it reduces the benefit of exposure therapy because people will say, well, I did that challenging thing, but I wouldn't have been able to do it if I wasn't taking a benzodiazepine.

Yumi
Oh, yeah. So if you're scared of catching a plane and you take a Valium, the next time you catch a plane, it's just as bad as it was before. Yeah,

Bronwyn
because you attribute the fact that nothing bad happened and that you coped OK, that you were on the medication rather than that actually you might have coped just fine anyway.

Yumi
Some of the women we've spoken to, Professor, don't like the side effects of their antidepressant medication. In common, it was the weight gain.

Bronwyn
So they're not alone. It's the number one complaint associated with antidepressant medication. And typically what ends up happening is that the person will be prescribed the antidepressant and then prescribed additional drugs to manage the side effects. And weight gain is absolutely a common problem. Really, the only approach is to either, if there's a medication available to combat that, take that alongside it or trial different antidepressants to see whether the side effect profile changes. It's a real problem. That sucks, doesn't it? Yeah, it really does.

Yumi
Because if that's the obstacle between a woman and her getting help, I just feel like it sucks.

Bronwyn
Absolutely. And I think it's important to just state that the benefit of psychological treatments here also can't be understated. So particularly if somebody is having side effects from an antidepressant, it's always recommended anyway that a person engages in psychological treatment. And particularly when coming off an antidepressant, engaging in psychological treatment is going to be really protective of relapse. So my advice for people who are experiencing those side effects of the antidepressants is if they're not already to be engaged in some form of evidence-based psychological treatment, because they may find that that mitigates the need for the antidepressant altogether.

Yumi
How dare you. That's fantastic. OK, what do you think of the argument that anxiety is over-medicated?

Bronwyn
I think that it comes down to patient preferences. We know that patients tend to prefer psychological treatments over medical approaches. But we also know that we're living in a time where it's really hard to access evidence-based psychological treatments.

Yumi
We also know that the wait lists for these treatments are huge. Another barrier for women is the cost.

Bronwyn
Antidepressants are cheap and you can access them right away. And they do have evidence. There is evidence that they work. So it comes down to what works for the patient. If they want psychological treatment and they can't get it, we really do need to change the systems. But if they are on an antidepressant and it's working for them, there is no reason why they shouldn't continue with them.

Yumi
And what about lifestyle as a treatment for anxiety?

Bronwyn
Lifestyle options are the bedrock of all good mental health. And so there's good evidence for exercise. There's good evidence for the role of nutrition. And there's great evidence for sleep. Sleep is just it all comes back to sleep. If you don't have good sleep, it's very, very hard to have good mental health.

Yumi
We're just going to all check ourselves into a hotel and pray for the best ever sleep. How can you sleep when you're worried about everything?

Bronwyn
It's really hard. It's really hard. And that's why part of the focus of therapy for insomnia is trying to address those worries.

Julie
One of the ways I was dealing with it was by drinking.

Yumi
This is MasterChef winner Julie Goodwin again. When she was in the pit of her anxiety and depression, Julie turned to an old friend, alcohol.

Julie
That's what calmed it all down. And that was damaging. It was hurtful to Nick that I would rather spend the night with a bottle of wine than with him.

Yumi
It wasn't just her husband, Mick, that Julie felt she was letting down.

Julie
I just felt like my inability to be happy was detrimental to my children. I'd raised them to always look at the positive side and I'd raised them to be strong and capable. And I felt none of those things. I felt no joy. I felt no strength. I felt no resilience. I felt no ability to look forward. And so I thought by my very existence, I was creating a terrible example for them.

Yumi
At the start of 2020, Julie made a plan to take her own life.

Julie
I went to the waterfront one night and I had decided that, you know, I was going to do what I considered to be the best thing I could possibly do for my family.

Yumi
Thankfully, a couple who saw Julie that night stopped to ask if she was OK and checked on her again to make sure she called Mick. It was after this night that Julie was admitted to a psychiatric ward.

Julie
That was not on my bingo card. You know, I literally could not believe what was happening to me.

Yumi
Julie was busy. She had a radio show and a business to run. But here were doctors telling her that she would need to stay in a psychiatric facility for treatment.

Julie
I remember turning to Mick to sort of, you know, nudge, nudge. Yeah, these jokers talking about. And he's just, he was just white. And I just went, babe. And he said, it sounds right to me. And I, wow, I felt like I'd fallen through the looking glass, you know. And then to walk into a place like that, it really shocked the shit out of me.

Yumi
Julie had a lot of preconceived notions about what a psychiatric hospital would be like. And let me just say that the movie One Flew Over the Cuckoo's Nest has a lot to answer for. But the experience was better than she expected.

Julie
And after six weeks in there, I'd lost a lot of those things and I'd learned a lot of things. And I came out with some tools. I came out with some more damage. Like they're not all fun and games, but there's certainly a lot to be said for handing yourself over. But I learned so much and I learned so much from my fellow patients.

Yumi
While she was in the hospital, Julie did cognitive behavioural therapy to help change her thinking patterns. She also started addressing the underlying issues beneath her anxiety. And she now had structures in place to try and stay well.

Julie
I still have to be aware. I still go to a psych. I have maintenance sort of sessions of once a month. I still have to keep a handle on my workload and that sort of thing.

Yumi
If Julie takes on something that she knows will fuel her anxiety, then she plans ahead for how she'll manage it.

Julie
I need to allow for that feeling. I need to prepare for that feeling and I need to recover from that event. So I've got to build in recovery time as well from something that I know is going to make me a little bit heightened. So I would say that I'm not cured of it. I just think it is actually a part of my makeup because I do want to keep putting myself out there. I do want to keep doing hard things. If I chose to live a life where I don't invite any anxiety in, then I feel like it would be a smaller life than what I have.

Yumi
Among the many tools Julie now has to keep her anxiety and depression in check, one of them is straight up acknowledging it.

Julie
Oh, hello. Hello. Hello, darkness, my old friend. Hi, anxiety. You sneaky little bugger. You've wormed your way in today, haven't you? Let's have a chat about that. You know, once you can name something, once you can see something and name it, it's no longer the monster under the bed.

Yumi
In hospital, Julie discovered swimming laps and she credits moving her body as a major part of her recovery.

Julie
Yeah, exercise has been really important and it's so boring, you know. It's so boring to say that and nobody wants to hear it because we all kind of know, don't we, right? Oh, my God. But for me, it's been about finding what I like. I love nature, but I don't like walking. Mick loves walking. He would walk anywhere. So if it's further than the driveway, I'll drive, thanks. But I love to swim and I actually, and I apologise, I can hear myself, I've come to really enjoy going to the gym.

Yumi
The road to recovery has been non-linear for Julie and she still sometimes veers off track. A key factor has been quitting alcohol for good.

Julie
That was the last piece I knew had to happen in the puzzle. Should have been the first piece, but, you know, we've got to come to it as we can, don't we? You know, the teacher arrives when the

Yumi
student's ready. Can I just point out that you dedicate your book to Mick and your beautiful love story. It sounds like he has been a huge part of helping you through the darker times.

Julie
Yeah. I wouldn't be here. I wouldn't be here. It's really quite straightforward. And I am well aware that not everyone has that kind of relationship or that kind of support in their life. I am so grateful to him. It's been 36 years since we started going out and we've been married for 30 of those years. And I am a very, very lucky human being. And I would just say that if you've got someone like that in your life, just love them as hard as you can and let them love you back.

Yumi
Like Julie, Julia also has a supportive partner who helps her manage her anxiety. If she's having a panic attack or feeling overwhelmed, he's next to her.

Julia
He's really patient with it and talks through it with me and reminds me that, you know, all that matters is him and our dog Murray and me. Like, that's all that matters. And everything else is just noise. You know, it doesn't matter. Let's we've got time. Let's just breathe through it, sit through it.

Yumi
Over the years, Julia has struggled to find a psychologist who's the right fit. But now I've got a new psychologist and she's really good. Julia also practices mindfulness exercises, but finds that if she's already in a state of heightened anxiety, she can't concentrate. During these times, she squeezes and releases different parts of her body.

Julia
And because that's a physical thing that you're doing and you can feel it and then release it and see how. That kind of like releases the pressure. I'm doing it right now. Yeah, exactly. Like, you're like, OK, well, I can feel that. And it's easier to concentrate on than just drawing my attention there. If my brain's already full of 12 billion other things. Tell me about Murray, your Dalmatian. Murray, he's a cutie. He gets really in tune to when I'm having an anxiety attack or when I'm feeling extra anxious. Dogs are just the best because they always feel that and they're there. Yeah, he just sits there, puts his head on my lap or like licks my tear if I'm crying. It's just it's too much. He's so beautiful.

Julia
I know he's the cutest.

Yumi
Yeah, that's so great

Julia
He's a good boy.

Yumi
Oh, I'm going to cry now. Also, I want Murray.

Bronwyn
I'm a firm believer in those foundations.

Yumi
Professor Bronwyn Graham isn't just putting in the research when it comes to anxiety. She's also practicing her own gospel to stay healthy in body and mind.

Bronwyn
So, yeah, I do a lot of running. I also think my superpower is sleep. For as long as I can remember, I've gone to bed at 930 and... Me too. We're such party animals. Yeah. Yeah. And I get really cranky if I'm invited to an evening event because I know it's going to disrupt my sleep. Yeah. But I genuinely think that those for me are the crucial ingredients because I know that when I don't get to run, and when I don't get to have that sleep, I'm a wreck.

Yumi
OK, so you just put those pillars in place. And you don't deviate from them. That's right. The gift I've gotten from speaking to Julie and Julia and Professor Bronwyn is the understanding that anxiety, as terrible and common as it is, can be significantly helped by making changes to your life. From the huge sacrifice of quitting alcohol to the huge pain in the ass that is daily exercise, from medication to therapy and that important pillar, getting good sleep. These things may not be sexy and they may not make great Instagram content, but they can help you build a life where anxiety doesn't have a stranglehold on your every moment. Like scars and trauma, anxiety may never completely go away. But if we allow for it and allow ourselves the kindness of doing what we can to manage it, we can go through life kicking both goals and kicking ass. For the last episode in our mental health series, we're looking at how you can look after yourself when you love someone with a substance use disorder.

Victoria
I think the most problematic thing regarding his drinking was fear. Fear of what could happen. Fear for the children. Fear for our relationship. And wanting to play happy families. And that wasn't happening.

Yumi
This podcast was produced on the lands of the Gundungurra and Gadigal peoples. Ladies, We Need To Talk is mixed by Ann-Marie de Bettencourt. It's produced by Elsa Silberstein. Supervising producer is Tamar Cranswick. And our executive producer is Alex Lollback. This series was created by Claudine Ryan.