Life's Booming
Zeroing in on mental health with Mary Coustas & Dr Charlotte Keating
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Episode notes
Here we delve into another aspect of our health that is often less spoken about: mental health. Older people are more likely to experience contributing factors to depression and anxiety, such as physical illness or personal loss, but how many seek help? In this episode, comedian Mary Coustas (aka Effie) shares her very personal story, and we get insight from clinical psychologist Dr Charlotte Keating on how to better care for your mental health.
About the episode – brought to you by Australian Seniors.
Join James Valentine as he explores the incredible stories of Aussie characters, from the adventurous to the love-struck. Across 30 inspirational episodes, Life’s Booming explores life, health, love, travel, and everything in-between
Our bodies surprise us in ways we never thought possible as we age, so in series five of the Life’s Booming podcast – Is This Normal? – we’re settling in for honest chats with famous guests and noted experts about the ways our bodies behave as they age, discussing the issues and awkward questions you may be too embarrassed to ask yourself.
Mary Coustas is one of Australia’s most loved actors, comedians & corporate speakers. In 1987 she became a member of the ground-breaking stage show ‘Wogs out of Work’, where her comic creation Effie was born. She is about to embark on a national tour, called UpYourselfness.
Dr Charlotte Keating is a clinical psychologist with a PhD in neuroscience, who runs her own private practice in Sydney's Lower North Shore. She is a passionate advocate for everyone's mental health, and has a particular interest in helping executives, parents, and young people.
If you have any thoughts or questions and want to share your story to Life’s Booming, send us a voice note - [email protected].
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Produced by Medium Rare Content Agency, in conjunction with Ampel Sonic Experience Agency
Transcript:
James Valentine: Hello and welcome to Life's Booming Series 5 of this most excellent and award winning podcast. I'm James Valentine and in this series we're going to ask the question, is this normal? I mean, as we age, stuff happens to us. Our bodies change, things fall off, we get crook, stuff doesn't work as well as it used to.
There's nothing we can do about it, we're getting older, we're ageing. But which bits are normal? Which bits do we have no control over? Which bits can we do something about? That's the kind of questions that we're going to be asking in this series, Is This Normal? of Life's Booming. Now, of course, if you enjoy this series, leave us a review, tell all your families and friends about it.
And we want to hear from you as well. You can contribute to this. If you've got questions about things in particular that you want to know, perhaps there's some particular wear and tear happening to you, let us know. We'd love to see if we can answer that question in the series. We're going to look at things like menopause, gut health, mental health, lots of other burning questions.
So think about those areas. And if there's something in there that's specific to you that you'd like us to cover, let us know.
On this episode, we'll delve into another aspect of our health that is perhaps less spoken about, zeroing in on mental health. We'll be speaking to clinical psychologist Dr Charlotte Keating, who is currently practising in Sydney. But first, let's introduce someone you might know as Effie, comedian Mary Coustas.
Well, hello. So we're going to talk some mental health. We're going to talk about these kind of things. What affects you as you get older, how you deal with it as you get older, what changes. What have you noticed, Mary?
Mary Coustas: Here's the thing. I love contrast. I love contradiction. I like all those things that when put together make for a more interesting mix.
You feel more yourself, obviously, with age. You've worked through what matters and what doesn't, and hopefully you've found a healthy place to put what you've learned, either in practice or out there into the world. And I do it through laughter, mostly. But your body goes through something else that you should have anticipated, but you didn't.
So I found the whole menopause thing really tricky, particularly for me, because when I was going through perimenopause, I was doing 10 years of IVF. So it was hard for me to know that I was going through perimenopause because I was taking IVF drugs, to have my now daughter. So then I missed that.
And then I was much later, I came to motherhood late. And so then after I gave birth to my daughter, I was going through menopause, but you think because women are so accustomed to discomfort – and I'm not talking about marriage – sometimes it's that we don't connect the dots enough.
So I thought it must be because I've just become a mother and the hormones from that, and I didn't realise it was the menopause thing. And the menopause thing plagues us in many different ways, but mentally it's a big one. It was the biggest one for me.
James Valentine: Before that, I mean, it's a bit of a cliche to say that the comedians are often doing that because of anxiety, because of various mental health issues.
Were you that? Is Effie the outcome of that?
Mary Coustas: No, I mean, yes, I had anxiety. I had a dying father. That doesn't help. Like he was unwell from before I was born. So that was the only true anxiety, apart from the racism that I encountered and then turned into a career.
James Valentine: Yeah. You mentioned that, like, Effie's a response to racism. I suppose I hadn't quite realised that. Explain how that came about.
Mary Coustas: Well, I was very confident growing up in a working class multicultural suburb. And then we moved as a family. My dad was very much a bigger picture sort of guy and said, we need to go where you can get a better education.
And unfortunately that was in a very white area and I was the little seed. From the multigrain that made it into a very wide area. And I was spotted immediately. You know, everything about me. I was very into fashion. I had my Suzi Quatro haircut. I was on it. I paid a terrible price for that. For being different.
James Valentine: How old were you?
Mary Coustas: I was nine. And it peaked I think a year or two in, and I just couldn't find a way to make it work for me. I was ostracised and it was tough. It was very, very tough because it was coinciding with my dad's health. And it was a very defining moment for me.
And I hated the suburbs. I still get a little bit, oh god, I've got to get back to the inner. Because I feel like that's where we celebrate togetherness a bit more. We don't drive up a driveway and close the garage door and say goodbye to the day and everyone around us. I don't like that isolated feeling.
So, the minute I stood on stage during my high school years, in musicals, which is ridiculous, I don't sing at all, but I mime brilliantly, I just went, okay, this is my stage, and this is where I can express myself. The Greeks built this thing thousands of years ago and they knew something and it's my thing and because I love the older generation so much and their stories, and this is beautifully folding into the conversation that we're having.
I was never bored with that generation and what they'd experienced in their village stories and how they came to Australia and what that was like for them. So the marriage of that obsession with the older generation, with finding a healthy outlet to express the big noose that was hanging around my social neck, which was race, Wogs Out of Work happened.
I served Nick Giannopoulos as a waitress. He just graduated from acting school and so had I. I didn't know him. But then he told me, we went to the same primary school, the same Greek school. I mean, it was just so bizarre. And then Wogs Out of Work happened and that was the thing that changed the conversation in Australia.
It was such a humongous stage show that really addressed the elephant in the cultural room and then discovered that the elephant was the best thing ever. And there were lots of elephants and there were giraffes and big lions and so I think the world has changed. Well, certainly mine has.
And I think there are a lot of people out there that are now super confident. And Effie was the perfect way to illustrate a young girl like so many Greeks. On paper, Effie would appear as failed, I would imagine, her English isn't great. She's working class. She's primarily uneducated, she left at Year 10, went and studied hairdressing.
Walks into any room, whether it's with the prime minister in the room, which I've done a lot of, that high-end corporate stuff. Any room, any place feels worthy, feels relevant and still 35 years in, is that example of someone that is because of self love.
It's funny because my current stage show is called Upyourselfness, and Effie, in that, says it's the only immunity we have left is to love who we are. And in the show prior to this one, this one is about political correctness and language. And as I said, Effie's never been great with language, but she's been great with feelings and demystifying things.
The show before this one, Effie talked about lockdowns and COVID and she admitted to her own mental health issues. So I think she's a great mouthpiece for me to express so much of what I want to say about the world. She comes in a very animated form and I think people believe everything she says because it is based in truth, my truth. And then I wrap it up in her little boofy exterior and accent and put it out into the world. And so she was born out of necessity and out of my truth.
But yeah, I'm a very hyper sort of person, never been diagnosed with anything other than plenty of energy. And if I look at my mother who's 85, she's got plenty of it too. So I've used energy, and we were talking about this before we started, about how it's important to put the right words with things and then sometimes you can conveniently put a different word that makes it sound better or worse. Some people would look at, say, adrenaline and think that it was adrenaline rather than anxiety because it is a rush and it is something that you can put a positive spin on.
I've seen a lot of people that have built great lives and careers out of using adrenaline, and then manifests later as an anxiety. So I am no expert in this. I know what I've gone through.
James Valentine: That's why we've got Charlotte. It's okay. Good. You know what you've gone through.
Mary Coustas: Yeah. And I believe that if you're a human being, you're going to have mental health issues. We're feelers.
James Valentine: Is that true, Charlotte? Is that an accurate observation? We're human beings, so we're going to at some point deal with, it could be anxiety, depression, whatever the label, we're going to deal with something.
Dr Charlotte Keating: Yeah, I think it really is. It's incredibly common, one in six people across their lifespan will experience some sort of mental health challenge, be it depression or anxiety.
So I think most of us have either experienced it or have known someone who will, or has.
Mary Coustas: I suppose when I say it, I mean like we're all going to experience grief. We're all going to experience sadness. I mean, not the greatest hits of what we know mental health to be these days, which is a handful of really intense feelings.
But I'm just talking about being human. Talking to somebody who's going through something very difficult that you love, or seeing a stranger you don't know on the street that evokes the empathy and all those beautiful things that reminds us of how human we are. We can't have all those feelings without suffering through plenty of them, whether they're directly ours or not.
James Valentine: Is it, Charlotte, what that Mary is describing is the anxiety, the depression, those kind of things, those mental health issues – is it when those feelings are too much or become extreme? Or is anxiety, depression, something else?
Dr Charlotte Keating: Yeah, I think it's a really important distinction, James. I think for people who are experiencing depression or anxiety, sometimes those can be emotions that go with everyday life.
I think certainly for older Australians, who perhaps have had less opportunity or exposure to the sorts of knowledge, awareness and information that younger Australians have today. They can often, I was thinking about what you were saying earlier in terms of your journey, they can go to the GP and perhaps present with, I have a lot of adrenaline, or I'm feeling quite tired, and not necessarily link those sorts of symptoms to perhaps there is something going on, physical or mental, that could represent perhaps more than just feeling off.
I think sometimes we might feel off for a couple of weeks and we might just put it to the back of our mind and keep going. And it can be after really having let it go for some time, that in fact if you do have a chat to your GP or you do have a look, you're like, actually I've been feeling not quite myself for more than two weeks. It could in fact be months, maybe even years.
And whether it's low energy, low motivation, lack of enjoyment or pleasure in the things that might have typically brought it, perhaps even difficulty doing the things you have to do, even things like self care, memory, attention, all of those sorts of things we go, oh, that's probably because I'm tired or or what have you. They can be signposts that there is something going on that possibly you could get some help and support.
James Valentine: But I suppose for a lot of older Australians, it's also the thing to do with those things was to put it to the back of the mind, was to just go on, was to not sort of, what's all this stuff about, mental health? We didn't do that. We just got on with it, Charlotte, you know, it's all very well for you and your fancy diagnosis. We just got on with things.
Dr Charlotte Keating: It's absolutely true, James. And I was having a little look at some of the statistics on help-seeking, for Australians. And certainly for younger Australians, just for a point of comparison, 14% of 35 to 44-year-olds will seek help for their mental health concerns. Whereas 6.8% of 65 to 74-year-olds will seek help. I was actually heartened that there was a percentage of people who would.
James Valentine: Doesn't sound like many though, does it?
Dr Charlotte Keating: It doesn't.
James Valentine: In either group, really?
Dr Charlotte Keating: In either group, exactly. When you can consider the impact it can have on daily life and functioning. But 95% of older Australians see their GP and the GP is the first port of call often for being able to help with these experiences.
James Valentine: I was really struck by what you said, Mary, when you said women are used to experiencing discomfort. And so, therefore, perhaps tend to just roll it into, aagh, it's another one of those things that happens to me.
They're not recognised, necessarily, that it could be a mental health issue.
Mary Coustas: It's funny what Charlotte said. I know a lot of older people that I'm close to that go to their GP to probably deal with more mental issues than physical ones. I mean, they're there way too regularly and if you have a good GP that is a good listener and loves what they do and loves their patients, you go there and I think they were stoic. They had to be. These conversations weren't being had then.
And I've been inspired by that generation so much for so many reasons. Sometimes you just have to force yourself to get on your feet and keep moving. I've experienced that personally on occasions, where just too many things happened at the same time that were too heartbreaking for me to be able to pretend it didn't. There was no hiding from heartbreak and grief and trauma and all those things, but I just think that a lot of people are terribly lonely and I think a lifetime can yield a lot of upset and grief and loss. Potential loss of physical capacity, loss of people you've loved, loss of opportunity, loss of all of those things.
James Valentine: I wonder, Charlotte, if we're on two different streams here. The difficulties of life are one thing, and the extreme difficulties that Mary's describing there that so many have dealt with, that she's dealt with herself, will bring rise to moments of tension, of pain, of anguish. This is different from mental health?
Dr Charlotte Keating: Oh, it's a really good question. I think what we're really deciphering here is how do we respond to what life involves, what the journey involves. I think it's probably fair to say by the time people have lived multiple decades on the planet there is a sense of stressful life events and experiences that they've all, that they've all had. Some are certainly worse than others.
There can be a compounding effect to some of those. When we think about war or we think about growing up in other countries and things like that, there's all sorts of cultural differences as well with how we process those experiences and in fact, grief and loss as well.
And I think that can also lead to questions we ask ourselves about what is normal, with respect to how we process grief, how are we supposed to do it, when is it that it might be important to perhaps seek some support in that way. You've described some stories, certainly Mary, where I'd be interested in understanding more about your experience of grief.
I think for many people, perhaps it can be understood in the context of stages of grief. Kübler-Ross is someone that people are quite familiar with in the five stages of grief, being denial or shock, anger, then a sense of bargaining, what could I have done differently, and those sorts of things, with depression and sadness toward the end, and then some level of acceptance of what the loss might be at the end.
And those stages aren't necessarily sequential.
James Valentine: Yeah. Or even in that order.
Dr Charlotte Keating: Or even in that order, and I think that there isn't necessarily a timeline, everybody's lives are so different. Their experience is so unique, together with their own sort of personality constructs and uniquenesses.
And so, I think if you are listening and you're in a process of grief yourself and you're wondering if you might be a little bit stuck in some of that processing and as you said, Mary, it can be because sometimes there hasn't been a culture of being able to express emotionally or talk about experiences. So you might try and busy yourself or distract yourself or find ways to try and push it aside.
But it does come out, we are biological and physical beings, it's important to be able to express it. And so I would recommend if there is grief you're going through, that's really persistent, very painful and difficult, you're finding it hard not to excessively avoid, or perhaps overthink the challenge at hand, it's really impacting your capacity to get on with your day-to-day, I'd recommend having a chat with your GP about it, or if a loved one you can see is experiencing that, try and talk with them about it.
James Valentine: I suppose we don't have to think of it in terms of when we go to seek help, GP, psychologist, psychiatrist, whatever it might be, we don't have to see it in terms of there must be something wrong with me.
Dr Charlotte Keating: That's it.
James Valentine: That I've got a mental health disease. You know, we can go and talk for all sorts of reasons, and maybe I only need to go for half a dozen times.
Dr Charlotte Keating: Absolutely.
James Valentine: Maybe it's only a short period of time where you need to just be able to talk to somebody neutral, somebody who's not in the family, someone who's outside of the situation.
Mary Coustas: Yeah, look, there's a very healthy love of self when you allow yourself to express your journey and your feelings and it's not this taboo thing that we need to dismantle that instantly.
James Valentine: Have you sought help?
Mary Coustas: Yeah, I have. My dad's death was a massive loss, but that was not a tragedy. And then I had a grandmother who I was lucky enough to fly to Greece, my mother's mother, and my mum and I flew there and we were with her when she was dying and that was an honour. And that was the perfect death. You know, she was 93. That was all brilliant.
But I lost a child. And that's a very different loss. And I was given a superstar grief counsellor who is probably one of the most impressive humans I've ever met. Has done better work than I don't know what else. I mean, a brain surgeon would do it with a knife. She does it with openness and no judgment.
And she navigated me through what was territory I never dared to imagine, and even beyond that. When I was then pregnant with my now daughter, I was worried that that would rob me of the joy I was finally faced with. And so I had to go and see someone. But someone alerted me to that.
My obstetrician, Vijay Roach, super duper star, he's the one that got me Deb de Wilde, who was my grief counsellor. He said, I think you need to go and talk to somebody because he knew my concerns. I'd worked so hard to finally get what I wanted and I didn't want to be in denial of what I'd experienced prior to that.
That had happened, but I wanted to put it somewhere healthy and I went and saw somebody and they said, look, there's two ways you can deal with this, you can tell yourself that it's a fear fantasy and you've concocted it, but that doesn't work for you, that wasn't a fear fantasy, that was a reality you survived. So let's take that one off the table, and let's just accept that you have these feelings, these feelings will come and go, and you let them pass through you.
And I did the work. She gave me some exercises to do, and I've got to tell you that on the day of my daughter's birth, I went back to the same hospital where my other daughter had died, and I was in, literally, in the same spaces with the same faces. And I did not connect the two until there was a male nurse that got put on. And he'd also lost a child. And he approached me just before I went into the theatre to deliver my daughter. And it came through another human being. And he said I needed to see the happy part of the story. He was wanting to build up his hope for what was ahead for him. So it happened in the most perfect way.
James Valentine: That was a good moment because I could almost imagine, oh, why did you choose this moment to come and talk?
Mary Coustas: Oh no, it was a great moment. And then we had a bit of a cry and I went in and then I was so present to what was about to happen and then when I was being wheeled out holding onto my daughter, high as a kite, I looked at him and we smiled. It was just beautiful. It was like something in the movies, you know.
James Valentine: Yeah. Charlotte, as people age, unfortunately, these kind of moments will happen, a child can die. Not necessarily in birth, but your 20-year-old, your 25-year-old. You’re 60, 70, 80, your child can die. Your partner can die. Your friends start to die.
You yourself will start to face things that are going to be extremely difficult. And again, I wonder whether we conflate these things into, you'll only go and talk to a psychologist or counsellor of some sort, the priest when it's really extreme, or if you've actually got some sort of mental health issues.
Again, this is not the case, is it?
Dr Charlotte Keating: Yeah, I think it's shifting a little bit, James, but I think it has long been that challenge of, oh, unless I'm really at breaking point, then that's for somebody else who really needs it. That's not for me.
James Valentine: I had to have had a nervous breakdown.
Dr Charlotte Keating: Yeah, I think that's exactly right. And I think that as you just both described, life is full of challenges and losses at various different stages, whether it’s when you're trying to start a family or, as you get older, family members might have challenges or problems going on themselves. It could even be in the context, there were things we don't ordinarily think about, say retirement, and moving towards something that you've derived a great deal of sense of self worth, purpose, meaning.
There's a change in one's sense of self or identity that can surround that and even things like irritability and anxiety can be linked to those but people don't necessarily know. Sometimes they do, but they don't always necessarily know and sometimes it'd be so valuable, as you said before, Mary, having a conversation with someone who really can change the trajectory of subsequent experiences you have, not even just the one that you might be seeking some sort of counsel for.
Mary Coustas: Yeah. And I also think with these conversations, the people that will help you get on the road to alleviating some of the discomfort of being human are not often the doctor. Someone else will tell you about it, you will have a conversation, this is where it's important we stay close and we keep talking to each other.
And I don't want this to be simply about what is difficult because there are so many great joys. And if you can get to those highs, you're going to get to those lows, you know? But friends or someone like in my case where people have said I had an issue, with something like that, you should talk to. And it just makes it feel much more natural and less taboo-ish if it's coming from someone who's done it themselves.
And we need to keep reminding ourselves. That's why campaigns like R U OK? Day and all of those beautiful things that people have put out there, just to remind ourselves that some days are going to be better than others.
And there are memories and triggers everywhere for us, especially if you've gone through difficult things that can evoke those feelings to come back up to the surface. And we know that community is a huge part of what makes people happy in that whether you're watching the Blue Zones documentary series or listening to people from The Happiness Institute or wherever you go to find your insights into what is healthy and what breeds longevity.
And it is community. And it is a priest, in those days, or an older family friend that perhaps isn't directly in your family, or someone you can go to and talk to about the things that are weighing you down. And I think that even podcasts like this are so useful to just say… You can't afford to ignore those things that are very difficult to get through.
We're not supposed to get through this stuff alone.
James Valentine: Yeah.
Mary Coustas: We're born in communities and surrounded by people, and we should take complete advantage of that.
James Valentine: And it makes me think that particularly for men, as you say, are perhaps not as accustomed to talking, not as accustomed to having those sort of friendships that women have, that I'm often quite jealous of.
It's like, how come you've got these four friends you go and talk to all the time? Men need to cultivate that. Men need to learn to cultivate that, and perhaps particularly in retirement, those work contacts have gone, and you need to learn how to have those conversations that are intimate, that are real, and have that group of friends.
You play golf with them, you play tennis with them, it doesn't matter what the initial contact is, but start to change the nature of the conversation at the bar afterwards.
Mary Coustas: But don't you think golf, the reason why it's taken off so much is two: one, you're competing with yourself, right? And that's the healthiest competition there is, as far as I'm concerned. I always say to my daughter, you're not competing against anyone else, you're competing against yourself.
But also it allows for talking time between moments, and I think that's why particularly so many men are drawn to golf.
James Valentine: Yeah, that's right. But I think this is something, Charlotte, for men to probably deliberately consider, you might need to deliberately think about cultivating that group that's perhaps got a different kind of talk going on.
Dr Charlotte Keating: I think that's right, James, and I'm hesitant to say, but I almost want to say, watch what the women around you do, and try and go, okay, well, that's what they talk about, or those are the sorts of things maybe I can do that too. I think as well, there's leaps and bounds being made in places and spaces like the Men's Shed, definitely a place where the capacity to be vulnerable and connect and really talk honestly is created.
And I think if you're going for exercise in the morning, you can often see perhaps the end point of the cycling gang, they're having their coffee and they're actually just talking and chatting a little bit.
James Valentine: But stop talking about bikes, fellas. Come on.
Mary Coustas: Stop avoiding the real issue.
Dr Charlotte Keating: I wouldn’t argue with that. But I think it's trying to take the opportunities where they might present and then also thinking about what sorts of hobbies and things do I like doing? Maybe I've played golf once every couple of years or, if I had to, maybe I'll actually pick it up with some determination. Or tennis or cycling or walking or swimming.
Mary Coustas: Or in the case of the Greeks – because I spend a lot of time in Greece, I've got a house there and all my family apart from my mum and my brother are in Greece – the men meet every day and have coffee. Every day.
James Valentine: Do they talk? Do those old men sit there and talk?
Mary Coustas: They talk about everything.
James Valentine: Real stuff?
Mary Coustas: Real stuff. Greeks, we like to think that our feelings live on the outside of our body. We're very verbal and expressive.
James Valentine: Right, right. If only you could keep some in.
Mary Coustas: Yes, exactly. Do I really need to know that every little detail?
But you see them and my house is around the corner from the oldest cafe in the area and they gather there every morning. And they play backgammon and they chat about what's happening with their kids, and their grandchildren and what they have to do that day, and then they meet up again, either later when it cools down again for the evening, but they're out.
And I think one of the best things that you could do, and I say it to so many people when we're chatting about this, is you've got to be careful of the conversations you're having inside your head. And you've got to get outside of your head and into, all of you, into a physical world, into a social world. Because you can talk yourself into anything. There's no objectivity coming through that non-stop monologue that's happening internally.
And it's good to be able to go somewhere. Whether it's a doctor, whether it's a group of friends, start a new routine, have something to do that gets you up and out every day to, to mix with others, to learn from their stories, to be able to express yours. These are all super healthy things.
Dr Charlotte Keating: So well said.
James Valentine: Mary and Charlotte, what a beautifully rich conversation that was.
Thank you so much. Mary, thank you so much for your openness through all of this.
Mary Coustas: My pleasure. That's my favourite thing to talk about, is human beings.
James Valentine: Yeah, but the fact that you've been able to write about your suffering, and express that so publicly, so so well, that's so important too, and I thank you for it.
Mary Coustas: Well that’s one level of the therapeutic process is to be able to put it outside of yourself somewhere, whether it's in talking or in writing. I mean, I'm lucky that I'm in a public domain so I can put it out there for others to respond to.
And my whole career has been about dispelling taboos, and talking about the difficult things. And I wrap it in a capsule of comedy and that's what makes people happy. And it’s what makes me happy. And that's my antidepressant.
It’s a very joyful job, but I try to shove in as many issues in that capsule as I can to sort of liberate myself and everyone that's there.
James Valentine: You do it beautifully and joyfully and thank you so much. Charlotte, thank you for sharing your expertise. Great to meet you.
Dr Charlotte Keating: You too, thanks James.
James Valentine: Dr Charlotte Keating runs her own private practice on the Lower North Shore in Sydney and Mary is about to embark on a national tour called Upyourselfness. You've been listening to Series 5 of Life's Booming: Is This Normal? Another season will be coming along later this year, so stay tuned wherever you get your podcasts.
I'm James Valentine. Thanks for listening.
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