Shireen: Dr. Carla Marie Manley, a clinical psychologist and relationship expert makes her home in Sonoma county, California. In addition to her clinical practice, she is deeply invested in her roles as an author, consultant, advocate, and speaker with the holistic mind, body, spirit approach. Dr. Mainly specializes in improving professional and personal relationships through mindfulness and communication skills.

In this episode, Dr. Carla Manley discusses how your mental health is affected by a chronic illness and answers questions, like can stress cause diabetes. She will also equip you with tools to combat stress that can cause or worsen chronic illnesses and provide tips for how the loved ones of individuals with chronic illnesses can improve their own mental health.

Podcasting from Dallas, Texas. I am Shireen, and this is the Yumlish Podcast. Yumlish is working to empower you to take charge of your health through diet and exercise and reduce the risk of chronic conditions like type 2 diabetes and heart disease. We hope to share a unique perspective and a culturally relevant approach to managing these chronic conditions with you each week.

Welcome Dr. Manly.

Dr. Carla Marie Manly: Thank you for having me. It’s a pleasure.

Shireen: Absolute pleasure is ours. So with that, Dr. Manley, I want to start off by asking, how did you become interested in clinical psychology?

Dr. Carla Marie Manly: It’s one of those things where many people don’t know what they want to be early in life. Something in me did know very early in life that I wanted to be a psychologist.

I did not have a linear path. My family had different ideas for me and being a people pleaser at the time, I tried to go a different route, including law school. Eventually after, uh, quite a lot of time in the investment area, I decided to go back in, into the field of psychology and build on my master’s degree.

So that I could do my heart’s work, my vocation, and follow my calling. It was not, it took a little, you know, a lot of work to do that. And a lot of emotional and mental oh work. And, um, some relationships were broken as I decided to follow my path, which is sometimes what happens when we follow the path that we are called to do.

Sometimes we disappoint other people and I had to learn to be okay with that. And so now, Um, I’ve been a practicing psychologist for over 10 years now and I absolutely love what I do. And, and I’m just so, so thrilled to be able to, to give in the way that I do and support others in the way that I do.

Shireen: Can you talk a little bit about how the diagnosis of, and a life with a chronic condition can really affect one’s mental?

Dr. Carla Marie Manly: So when somebody has a chronic medical condition, I look at it as though you’re carrying around an infant 24/7, and sometimes this infant is very unpredictable and colicky and sometimes it’s somewhat peaceful and it will sleep, but I know many people and have many clients who have chronic illnesses and then they get very down on themselves.

Because there is so much stress of dealing with a chronic condition. So even if you’re able to, as society often wants you to do, put on a happy face. Um, and I don’t think that that’s always the healthy thing to do. But I do believe that when you are dealing with a chronic condition, there is a constant, emotional, mental, and physical load that people who do not have chronic conditions simply don’t have to face.

So some people don’t understand how debilitating it can be, particularly if it’s, um, a chronic condition that they can’t see, or they can’t appreciate. Most people understand if you have cancer, right? And, but for most other conditions, people, they can’t see it. So they don’t want to validated it or appreciated it or really move in with lots of empathy and compassion.

Shireen: And so what tips do you have to help combat some of that stress?

So I think

Dr. Carla Marie Manly: that one of the most important things to do is to realize first and foremost, none of this is your fault. And that’s a really important place to stop, to pause and realize, you know, I am not the cause of this chronic condition and I am not this chronic condition.

I am separate from this condition. I have this condition, but it is not me. I will choose not to let it identify my life or identify me. So I think that’s one of the first things. I think the other thing that’s so important is to reach out for support. Sometimes we expect our medical practitioners to support us in really wholehearted ways.

And if we’re blessed, we do get a medical practitioner who does really support us mind, body, and soul. Many times, however, the medical practitioners are overboard and have 10 minutes to spend, and then you’re out the door. So you’re left feeling unsupported, unseen, and that can actually add to a sense of stress and depression.

So I think it’s so important to know that you deserve, oh, not, not just the, the, you know, medical support, you deserve good medical support and nothing against our healthcare providers out there, but some of them are so time pressured that they don’t see the individual. So I think it’s important to have somebody by your side and whether it’s a partner or a family member who can be your advocate, so that when you’re in with a medical practitioner, they’re there to ask questions to kind of push for you a little bit so that you don’t feel so stressed.

Because often we go into the doctor’s office when we have like this God complex, and we think that the doctor knows everything. So I do think it’s so important to have that kind of support. I also think it’s critical to have mental health support, whether it’s a psychotherapist, whether it’s a mentor, whether you have a support group or all of those, right.

Because sometimes people will tell me it’s an, it’s a really common that people will say, you know, my best friends or my mom or my husband or my wife. They’re so tired of listening to me talk about my issues. I wish I had someone else and sometimes starting a support group or joining a support group can be a place where you listen to other people’s issues at, or unload your own issues and you don’t feel judged and you don’t feel as if you drain other people.

So I think that is a really important piece to have the mental health support, which includes that emotional support. Another really important piece when you’re dealing with a chronic illness is self care. And so many people who are suffering from a chronic illness, confused being in the doctor’s office and having required downtime with self care. That’s not the same thing as self-care, an hour in the waiting room or, you know, an hour in the line at the drug store. That is not self-care. It may feel like you’re doing nothing, but it’s not self-care. And so self-care-what is self-care? Self-care is that intentiontional calendared time, not time that fits between the cracks, you know, where you just get, oh, I’ll, you know, have a glass of tea here.

Well, a glass of tea can be really good self care, but did you devote that time to your healing? Did you maybe sit outside or, you know, sit quietly somewhere so that you can really be in the present and allow yourself to enjoy that cup of tea as self care. So I really is see self-care as appointments so that the psyche says, oh, she’s giving me an hour here just to wind down and take care of myself just to be.

So I think that’s another really important part of dealing with chronic illness is to give yourself self care and to differentiate between self care and forced downtime or forced clinical time. I think another important piece is to engage in mindfulness practices, whether it’s meditation, whether it’s yoga or journaling.

So let’s talk about meditation for a minute. Some people will say to me, I can’t sit for an hour long meditation. That’s excruciating for me. That’s not a problem. Maybe you will sit for a five minute meditation or maybe you will go for a very slow walk and turn your focus inward and use that as your meditation space, maybe you will knit and crochet and just be in that zone of meditating while you do something like that. It doesn’t have to be a seated Zen type meditation. It simply doesn’t. It’s about allowing your parasympathetic nervous system to come on board so that the stress just floats away. So then what about yoga?

We often think of yoga in today’s world as being. High energy class, where you’ve got to look good and you know, do an hour of zoom, zoom, zoom, you know, and that’s not really the intention of yoga at all. Yoga is initially a body, mind, spirit practice about being in the present. So yoga can simply being in downward dog or doing a forward fold, you know, you bend over like a ragdoll and just, ah, feel good.

So you don’t have to do and be in high energy practice. You can do a more, you know, yin yoga that’s just very calming and peaceful for your system. And then journaling. How is journaling self-care? Well, journaling is one of my favorite tools for self-care because we often think of journaling as I must write. You know, I must perform for somebody else.

This must be a beautiful work of art on my page. Not at all. There is a type of journaling. I call free association journaling, where that journal is just your book, your space. To write and download and never to be read again, that it’s just your space to let go of toxic thoughts, toxic feelings. And if you want a journal like that, one of my clients dubbed them vomit journals, where she would just go and blah, into the journal.

So the kind of journals we don’t want to read again, they’re just meant to be a receptacle for all of that stuff you want to get out, which when you’re dealing with chronic medical issues, there’s often a lot of resentment and anger and depression. That’s like, why do I have this? Why am I picked to suffer from this?

Well, keeping that in your spirit is not healthy for you. And so being able to have a place where you just let it out without judgement.  You are not bad for having those thoughts, but what you want to do is just get them out of your system and if more, come up, get them out. And I liken it to like, when we physically vomit, we don’t really go and investigate what we’ve vomited. We just let it be and then we flush it down and now it’s gone. And so I look at when we have feelings like that, just get them out of you. They’re normal. They’re okay. They don’t make you a bad person. They make you a person who is responding to the stress of dealing with a comp with a chronic illness.

Shireen: And you talk about the individual. I want to shift gears now to maybe a family member. How might this impact that relationship and the mental health of the family member, especially when talking about a spouse and what can individuals do to reduce such burdens?

Dr. Carla Marie Manly: Hmm, that’s a good question, because you know, I’ve had loved ones who have had chronic illnesses and, um, it’s very taxing, particularly if you really love the person and you’re a caregiving type of person. For people who don’t have high empathy or high level of cares, having a high level of care for others and there are people like that in the universe that having, somebody who’s suffering from a chronic illness can be like, Hey, you deal with it. It’s not my. problem

Well, that’s its own issue. And I’m not really speaking to that population because they tend to not allow themselves to be effected. But for those who are caregivers, who really are behind their loved one and want to be there for someone, I would say the most important thing to do is not judge yourself for not being able to fix or cure or be all and do all. I believe that for the person who is the character it’s also important to engage in good self-care to know when you need help to do your  best to show up when you can, but to also have a lot of healthy balance inside of you and realize you are not God, you cannot fix this.

You can be there to support and to the faciliate and nurture, but that you too have a life that you must keep going, so that you can be there to care for yourself and care for others. And in the same way, it mirrors a lot of the parts about the person who is suffering from the chronic illness is to get the support you need sometimes.

You will need a support group for, you know, people who understand how taxing it is to be a caregiver, particularly in the longterm. If you’re dealing with someone where there is, you know, long-term caretaking different from, if you’re caring for someone who has heart surgery and you’re caring for them for three months during, you know, the true recovery phase. That’s very different from caring for someone who has a condition that is unremitting. And so really, and the other piece that I say is find a schedule that offers you consistent and see, and that is so important all the way around because the more consistency we have in our lives, the more predictability we have, though like taxing it is. So if we know, Hey, we’re doing meals at eight, noon, and five, we are doing baths at, you know, 7:00 PM. We are, you know, doing our exercises at 1:00 PM, whatever it is, that way you can look at your schedule. And if you’re sharing duties with someone else, have them be part of that scheduling so that you can look forward to your spaces of downtime and you see them so, so often when we’re caring for others, it begins to feel like a big blur. Where it’s just like, oh, I’m doing this 24/7 when sometimes you actually are. And sometimes you aren’t, but it feels that way. And a schedule will help you back off, have a little more objectivity. And if you aren’t getting spaces, it will help you see where you do need to get spaces of self-care and time for yourself, regenerative time. And so I think schedules and consistency all around are a win-win.

Shireen: What is the link between diabetes and depression and what does this mean for our listeners here today?

Dr. Carla Marie Manly: So diabetes and depression, that link, of course, you know, the body and the mind are so connected and when diabetes be it not so much for type 1, but for type 2.

Um, there are parts of it where it’s such a high level of stress that we live with today can certainly contribute to diabetes and always trying to achieve and never getting there. And never right there, you can start that cycle of anxiety, stress, anxiety, depression. So that’s, you know, part of it to begin with.

But then when you’re in the throws of diabetes, whether it’s type 1 or type 2, it is so easy to get stuck in places of depression, because of one of the illnesses that I really feel is very much like having an infant is diabetes, where you always have. I have a very dear friend who suffers from type 1 diabetes, and I have helped her understand and clients who suffer with it. But I have helped her understand that it is like having a constant infant. It wakes her up throughout the night, her, you know, buzzers going off, she’s having to adjust her insulin it’s as though she has had this infant, it doesn’t grow. It never gets better.

It never matures. And so, and so talking about it through that lens of saying, wait a sec, Imagine if in real life you had an infant and somebody gave you a five day old infant and said, here’s a colicky infant. It will always stay five days old. You must always adjust your life to tend to it. It really helps you have compassion for yourself and understanding.

And so the more we have self-compassion, the more we have understand that. That this is what it can feel like. So the best we can sometimes do is manage it. That helps us not get into that place of depression, because then we understand, oh, this is much like a colicky baby. So I need to do my best to tend to the baby.

Not get depressed that I have a colicky baby, but tend to it and do my best and engage in self-care. And here’s another piece with diabetes and depression. I’ve also noticed that many people who have diabetes get angry at the diabetes, and they want to get into a fight with the diabetes. And so there, diabetes, I’m going to have five pieces of cake.

So there, because I can, and I’m mad at you. Well, it’s very understandable because you’re coming from a place of anger and depression and feeling as though, you know, every time you turn around, there’s a stop sign waiting for you about what you can’t do. And realizing that that type of response is more.

But that if you go down that road, it will get you into that place of sinking and feeling depressed, and then get you into that cycle that ultimately harms you. So understanding that if you have those tendencies, you are not alone. They’re understandable. They’re common, but you do want to try to manage them much like that colicky baby.

You might want to go and yeah. Scream at it or something, but that’s not going to be effective. And so screaming and eating, you know, five pieces of chocolate cake. That’s not really going to be effective for you. And it’ll just put you down into that place of depression that comes from that sense, often a feeling of loss of control and a loss of power.

And so what’s so lovely is if you can switch that energy into seeing, well, I can’t control this, but where, what can I control? What in my life can I control? So we go back to the self care. You can control breathing exercises. You can control sitting and doing meditation. You can control your food intake. You can control your food choices. There are so many good-for-you foods out there that, so there are things to realizing, yes, of course in life, and especially with diabetes, there are many things you can’t control. That doing your best to become mindful about what you can control and focusing your energy in that realm.

And that really helps with depression overall, whether it’s stemming from diabetes or anything else, you know, so much depression comes from being angry at what life has brought you. And then, yeah, stuck in the negative mindset and thought loops and so realizing if I can get into some of the patterns of mindfulness and gratitude.

Yeah. Which can be really hard to do when you’re or suffering from chronic illness. It can be hard to get into a space of gratitude yet. Sometimes that is the very thing we need. I remember being behind a woman in the bank, in the bank. And she, I could hear her, she went up to the teller and she could barely walk.

She was quite elderly and she was suffering and walking with a limp and kind of to the listing, to the side. And the teller said, well, and how are you today, Mrs. So-and-so? And she said, I am fabulous. It is another day that I can walk to the bank and just listening to that and saying, wow, she had all of these issues.

You know, she had very thick glasses and could barely walk, but here she was being very grateful for that, that she could get to the bank. And so I use that as a constant reminder for me that no matter what we’re facing, if we can find the pocket. Gratitude. It does help. Not that we’re pretending to be happy, I’m not talking about that.

And I really want to say toxic positivity, pretending to be happy is not the antidote to depression at all. If you’re feeling depressed, it’s important to feel your feelings and understand where they’re coming from and not think you have to put on the happy face. That’s why the support is so helpful, but being grateful is different from toxic positivity.

Shireen: I like the differentiation between toxic positivity and then just being genuinely grateful.

Dr. Carla Marie Manly: Yeah.

Shireen: How can our – and this brings us, uh, by the way, Dr. Manly, toward the end of the episode, at this point I’d love for our listeners to, um, you know, connect with you, learn more about your work, where, where can they go and how can they do that?.

Dr. Carla Marie Manly: So listeners can find me on my website, drcarlamanly.com, and it’s spelled D-R-C-A-R-L-A Manly, M-A-N-L-Y .com. And this is me, Dr. Carla Marie Manly. You can also find me on Facebook, Dr. Carla Manly, Twitter, Dr. Carla Manly, Instagram, the same, and, um, LinkedIn, the same.

Shireen: And we will link all of this in the show notes. So folks can find it well. Um, with that, Dr. Manly, I want to thank you so very much for your time. I think everything that you said just resonated so well, and, um, just quickly, when you made a point about, you know, that, that frustration that comes after that diagnosis, that resonated so well with me. We have, we have patients that come through with Yumlish and, um, literally talking about food makes them emotional.

Understanding that there is, there are changes to be made and things to do and on top of life happening every day. Um, so that resonates so closely with me. We’ve had people cry, you know, burst into tears, um, because getting this diagnosis and then just managing life and especially not only having a diagnosis yourself, but on top of that, if you’re a caretaker for someone else. You know, that’s like, oh, that’s a whole another.

Dr. Carla Marie Manly: Another layer, another layer altogether. And absolutely realizing that that frustration eating food is so primary. It is, so we get so much joy out of it for many people, right? Especially those who eat, you know, I’m more of an eat to live, but so many people live to eat.

And the minute we’re told you can’t do this,  natural part of who you are that you’re so used to and so enjoy. Oh, it’s like cutting off some of your oxygen, right? Because oxygen, water, food, you know, it’s what we need. And so yes, it can be extremely frustrating and realizing if you’re feeling frustrated and angry and irritated about it, that’s normal.

It’s absolutely a normal response to being. You have to really shift this very basic foundational part of your life. And so feel your feelings, feel your irritation and do your best to not get over it, not get around it, but get through it. Through it, acknowledging who you are and what you need. And when you feel irritated about it, it’s okay to be irritated.

Shireen: I love that. I’m totally going to steal that. Don’t get over it, get through, got it.

Dr. Carla Marie Manly:  Get through it.

Shireen: With that, Dr. Manly, it was an absolute pleasure having you on this podcast today. Thank you so very much for your time.

Dr. Carla Marie Manly: Thank you.

Shireen:  To our listeners who are out there, head over to our social media, specifically to our Facebook to answer this question: what is your favorite way to destress and take care of your mental? Head over to our Facebook @Yumlish_ to answer that question. Thank you very much, Dr. Manly, for your time. We are giving away audio books of Dr. Manly’s latest book. Uh, Date Smart gives readers, um, uh, just clear, authentic tips and tools for creating healthy relationships, and again, you can find more information regarding that on our social media. Thank you so much again.

Dr. Carla Marie Manly:  You’re welcome. Have a beautiful day. 

Shireen: Thank you for listening to the Yumlish Podcast. Make sure to follow us on social media @Yumlish_  on Instagram and twitter and @Yumlish on Facebook and LinkedIn for tips about managing your diabetes and other chronic conditions and to chat and connect with us about your journey and perspective. You can also visit our website  Yumlish.com for more recipes, advice, and to get involved with all of the exciting opportunities Yumlish has to offer.

If you like this week’s show, make sure to subscribe so you can hear more from us every time we post. Thank you again, and we’ll see you next time. Remember your health always comes first. Stay well.

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