Working as a GP can be draining and exhausting, yet very rewarding, work. You know that you’re supposed to be looking after yourself to enable you to do your job well. You want to approach your life and work with energy, empathy, and care but sometimes it feels like you are scraping the bottom of the barrel. You are not alone.  You probably have a good idea about managing your physical and mental health – you probably educate your patients about it every day. But how often do you actually practice what you preach?

Here’s a reminder and some practical tips about how to actually fit this into your real, everyday life. It can be hard, seem near impossible to ‘find the time’ to take care of your own physical and mental health as a doctor. You are busy seeing patients all day, catching up on notes, following up results, going to seminars and completing professional development, keeping up to date, and you may be responsible for after-hours on-call for your local hospital or nursing home. You may have families of your own you need to care for, or you might be studying for fellowship exams. The problem is, to be able to do all of those things, you actually need to be at your best – so it’s important to prioritise self-care to enable you to bring energy and results to the rest of what you do. Relegating it to your leftover time at the end of the day means it will never happen. Think about each aspect listed below, think about when you can actually do it, schedule it in and give it a go. Morning usually works best but everyone is different, so find what and when works best for you.

1.     Mindfulness

Mindfulness can make a big difference to your life. Several practices can cultivate mindfulness such as yoga and tai chi but most of the literature has focused on meditation. Mindfulness is really about awareness without judgement, an acceptance of your moment-to moment thoughts and experiences.

Evidence from correlational research suggests that mindfulness is positively associated with a variety of indicators of psychological health, such as higher levels of positive affect, life satisfaction, vitality, and adaptive emotion regulation, and lower levels of negative affect and psychopathological symptoms (1).

You don’t have to create a perfect environment or have large amounts of free time to sit down and meditate. All you need is a 10-minute time slot prioritised into your day. Tip: try scheduling it into your calendar. Ideally, first thing in the morning before anyone else in your household is awake! However, even if there is background noise in the house, dogs barking, or someone screaming at their sibling in the kitchen, just do it! There will never be a “perfect time”.

Here’s one approach to meditating:
Sit down comfortably, take a few moments to listen to the sounds in your environment (just an awareness with no judgement attached), take a few moments to focus on your breath, close your eyes, conduct a slow body scan top to toe to check in and notice each area of your physical body, just allowing it to be, as it is, not trying to judge or change anything. Then spend a few more minutes focusing on your breath. You can count your breaths if that helps. Remember its normal for your mind to wonder off – again do not judge yourself on this, just be aware your mind has wandered and gently bring your focus back to your breath.

Some people like to use a mantra to focus on though just focusing on your breath (inhale… exhale) works well. It is interesting the types of thoughts that pop into your mind when you do this. Whatever the thoughts are, remember they aren’t good or bad, they just are. Notice them with curiosity and acceptance.

We recommend using this technique during your workday – stop, take 3-5 deep breaths. Stay calm. When we are running behind and we feel stressed, you can return to this. You can ground yourself with your breath. Initially it may feel strange but once you get used to it, it becomes second nature. There are helpful apps like Headspace or Smiling Mind if you’d like help.

2.     Exercise

We know you know this… but sometimes we need a reminder. Exercise is good for you. Exercise is an effective evidence-based intervention for osteoarthritis, back pain, tendinopathy, depression, diabetes and cardiovascular diseases (2). Doing some activity on most days of the week is beneficial and will keep you in a routine. Accumulate 2.5–5 hours of moderate intensity physical activity, 1.25–2.5 hours of vigorous intensity physical activity, or a combination of these per week. The ‘how’ will vary from person to person but if you aren’t currently exercising then the cheapest, simplest, least time-consuming method to start with is … walking! Put your sneakers on and go for a brisk walk. Like meditation, it is all about routine. If it becomes a habit, it’s not a chore or something you need to ‘try to remember’ anymore – it will be planned and routine-based; a staple in your life – like showering in the morning or brushing your teeth. Tip: try to add incidental exercise into your routine like parking the car further away or getting off the bus or train a few stops earlier.

3.     Healthy diet

This can be a little trickier as you are probably time poor. If you have a family to consider, it can feel more difficult. Planning ahead is the cornerstone of healthy eating. Tip: sit down once per week and plan all of your meals, order groceries online according to your plan and have it delivered. You don’t even have to leave your house!  Include lunch planning so you can pack your lunch and snacks from home so it makes it easier to eat well at work.

With all your meals planned in advance (and all ingredients in the house), it makes it much easier to have a healthy, vegetable-filled meal each day. Here is a basic week meal plan:

  • ‘Meatless’ Monday – (vegetarian dish for example Mexican beans, ratatouille, quiche, baked potatoes, lentils, tofu stir-fry, fried rice)
  • Tuesday – ‘slow cooker day’ (for example casseroles, soups, chilli, curry – always make an extra serve to freeze)
  • Wednesday – ‘fresh cooked’ meal (fish, salads, grilled meat and veg, BBQ etc)
  • Thursday – ‘freezer meal’ (night off cooking)
  • Friday – ‘fake-away’ (home-made pizza, burgers, home-made sweet potato chips, hot chicken, fried rice)
  • Weekends is usually an outing or take away and then a roast.

See how little thinking there is when it follows the same simple pattern but still with lots of flexibility and variety. Veggies are key – make all meals with loads and loads of extra veg thrown in. Lunch can be leftovers or salads or soup from the freezer; snacks are salad sticks, hummus, fruit, peanut butter on crackers. It’s all in the planning – which makes healthy eating very simple and stress-free.

4.     Time for leisure

Life is for living. Don’t forget to have fun. It could be ‘stay-cation’ in your hometown; a night away from home; a day a the beach; visiting friends; or a cup of tea and a book on your verandah enjoying the sun. Fun for you will be different than fun for others. Whatever it is for you – book it in, do it and enjoy it! Woohoo!

5.     Sleep

We are all guilty of not getting enough at some point in our lives. It might not even be your fault if you have small children in the house. Adults should be aiming for around 8 hours per night, although there will be some individual variation.  A gentle reminder – sleep hygiene recommendations include: having regular bed and wake-up times (including weekends), limiting caffeine and alcohol intake, regular exercise (preferably not too close to sleep onset), and to avoid napping too much in the day (3). If you’re studying for your fellowship exams, sleep is even more important as there’s a well-established link between sleep, learning and memory – see the Harvard Sleep Centre website for their research findings and great tips.

6.     The importance of connection

It is easy to feel as though you empty your ‘cup’ at work and don’t have anything left over at the end of the day for your kids, friends, spouse/partner or self. This is a big challenge for many people in our profession. If you come home every day feeling completely depleted, this will impact your wellbeing and your relationships with others. If you find it hard to carve out time for meditating, exercise, sleep, healthy eating and leisure because it feels selfish then please remember this will not benefit just you. This will benefit you, your family, your friends and your patients. At the end of the day, it is connection with other humans that matters the most in our lives. Ultimately, reducing your clinical workload and increasing time for the above self-care strategies and connecting with others may need to be considered to give you the right work/life balance.

Tip: If you are not doing any of the above strategies right now then we suggest you make one change at a time; get used to having that as part of your weekly routine for several weeks and then add another thing. Making gradual sustained changes is more likely to be successful than a sudden quick overhaul of your whole life.

Good luck!

References:

  • Keng SL, Smoski M, Robins C. Effects of Mindfulness on Psychological health: A Review of Empirical Studies. Clin Psychol Rev. 2011;31(6): 1041-1056
  • Orchard J. Prescribing and dosing exercise in primary care. Aust J Gen Pract 2020;49(4):182–86
  • Liotta M. How does sleep affect health? News GP. 2019. Available from: https://www1.racgp.org.au/newsgp/clinical/how-does-sleep-effect-health