Mark Gomez, MD [00:00:11] Hey, what's up, everybody? My name is Dr. Mark Gomez, but you can call me Dr. G., and welcome to Health 360 with Dr. G.

Mark Gomez, MD [00:00:21] Today's topic, hidden health dangers of loneliness and isolation. I tell you what, this show is all about you. And I'm so excited to talk about this topic, which is so pertinent given the circumstances that we're in right now. Now, the concept of social connection is not only a powerful one, but innately human. It's been present as part of us, as part of our human existence. And as such, it is important to explore the natural and sometimes complicated relationship between social connection and health. Although barriers may exist to making connections possible, sometimes it can be difficult or seemingly impossible, it is important to explore them and any accompanying feelings of isolation or loneliness. What matters most is to understand what steps can be undertaken to develop enhance social connections. Again, my name is Dr. Mark Gomez, Dr. G. I'm a board-certified internal medicine physician practicing out of Edward Hospital in Naperville, Illinois. I'm also a member of the American College of Lifestyle Medicine. You can check me on my website, www.Health360Podcast.com. When you're there, smash that subscribe button. Also check me out across all forms of social media @Health360wDrG. And while you're there, also smash that like and subscribe button. Allow me to be part of your health journey. So, I'm going to break it down today. You're going to hear some important terms as it relates to this theme of hidden health dangers of loneliness and isolation. You're going to hear about the term loneliness. You're going to hear the term social connection. You're going to hear social isolation. You're going to hear social network. And I also have a surprise term for you that you may have not heard. So, what I want you to do is I want you to grab a pen Health360Podcast.com. Pull up your favorite beverage, product placement - Health 360 with Dr. G., grab a sheet of paper. If you don't have pen and paper, pull out your smartphone just like this and go doot doot doot doot whatever it is -

Mark Gomez, MD [00:02:34] But I want you to document, write it down. There's something about writing things down that confers memory and action for you. The most important thing that you could do today is share this show with others that are out there who want to spread the message of continuing engagement. And my guests today are super fierce. Was so excited for you to meet them as we go granular, get deeper on this conversation to help you. Let us be part of your journey. But before you meet my guests, let me hit you with a quick disclaimer. The content of Health 360 with Dr. G. a Healthy Driven podcast is for your information and entertainment purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. So, without further ado, I want to introduce my awesome panel of experts to help me break this down, this topic of hidden health dangers of isolation and loneliness. My first guest, she and I are longtime friends, we're also classmates. That's right. Former classmates at Loyola University School of Medicine, a longtime friend of my family, myself personally, professionally, just an amazing individual. She's at the top of her game, y'all, and that is the truth. We've collaborated in the past and I'm so excited to welcome her to Health 360 with Dr. G. Let me introduce Dr. Kate Johnson. She is assistant professor, board-certified adult, the child and adolescent psychiatrist at Loyola University Medical Center. Dr. Johnson, welcome to the show.

Kate Johnson, MD [00:04:00] Thank you. It is delightful to be back again. And now in a new environment, yeah.

Mark Gomez, MD [00:04:07] Dr. Johnson it's so great to see you. You know, like in comic books, every character has an origin story. Briefly, what is your origin story. Tell us tell us what your students would call it your street cred. Tell us where you went to medical school, residency and a few opening remarks about this topic of hidden health dangers of isolation and loneliness.

Kate Johnson, MD [00:04:24] Absolutely. So as you mentioned, we were classmates back in the Cretaceous era - when we went to medical school, went to Stritch School Medicine Loyola University, and then I went on to do my residency, and that led to a fellowship at University of North Carolina.

Mark Gomez, MD [00:04:40] Wonderful. Please tell us a little bit more about this topic, a few opening remarks.

Kate Johnson, MD [00:04:44] It is a huge deal. And I think what we've watched evolve over the past year has really underscored how much we need each other right now and how difficult that is when we don't have our usual access to our usual ways of connecting. But the other thing that has been amazing to watch over the past year is the creative ways people have managed to maintain those connections. And I think when all is said and done, because COVID will end, we will get back to our lives eventually, and I really hope that some of the things we've been able to do over this past year, to be creative and connect in different ways. I hope that will come forward.

Mark Gomez, MD [00:05:24] That's wonderful. It's so great to have you here, Dr. Johnson. We're going to get deep in just a moment. My next guest, he and I go way back, actually first met him at the House of Blues in Chicago. Oh yeah, a little origin story, but everybody again has an origin story. Dr. Daryl Wilson, we'll introduce you to him. Dr. Daryl Wilson is a board-certified emergency medicine physician. He practices out of Edward Hospital in Naperville, Illinois. Dr. Wilson, welcome to the show.

Daryl Wilson, MD [00:05:51] Hey, man. Good to see you as usual, Mark, it's always good to see you.

Mark Gomez, MD [00:05:54] Great to see you, my friend. Give us your origin story. Tell us your creds. Medical school, residency and a few opening remarks about today's topic.

Daryl Wilson, MD [00:06:02] I wish that my origin story began with me eating the heart-shaped herb and getting to the powers of the Black Panther. But that's not the way that happened. So, but instead, you know, you know, I went to Loyola Stritch School of Medicine for my medical school way back before you two. You know, as I reached the age of, you know, shaking my fist at clouds and screaming, get off my lawn, as I've said to many people before. But, you know, I went to Loyola for medical school, of course, loved it, and then went on to do emergency medicine residency at Cook County Hospital, the Mecca for emergency medicine. And from there and I worked on the West Side for a period of time, worked on the South Side, initially at Provident Hospital on the West Side, and then came back home to Naperville. I graduated from Naperville Central in 88. So, back out here to my hometown and now here in Naperville. Now almost for, God, it's been 18, 19 years now. And you know, there with some of my colleagues who graduated from high school and residency with me. I'm the EMS Medical Director as well. So, in charge of all the paramedics out here and the topic of social isolation and loneliness and the deleterious effects on health, it's super important. And as an emergency physician, you see a lot of these effects where, you know, individuals have undertaken almost these pathological pathways with this, where there's effects on the health because of inflammation. We'll talk about this leading to poor outcomes in individuals health behaviors that unfortunately lead to antisocial behaviors that may lead to individuals abusing medications, abusing alcohol, all these things and the spiral effect that continues to lead to poor outcomes in health in general. And with this disease process of COVID leading to individuals not having those social connections as they typically would. It's very sad in some senses to see individuals who didn't have the ability to say that goodbye to some of their family members. But, you know, as you pointed out, you know, there's also this amazing resilience of human beings and the ability for them to find new ways to interact with one another and find ways to kind of build social connections and not feel so left out and lonely in a world that feels like they're getting more and more isolated. So, yeah, I'm excited to talk about this with everyone.

Mark Gomez, MD [00:08:41] This is awesome. So, there you have it. You've met the crew, Dr. Johnson, Dr. Wilson. And how the show works, I'm going to ask some questions and we're going to give you some answers. Going back to again, write some things down, spread this message of engagement opportunity. You're always going to get it real for me. You're always going to get the forever optimism of me. Yes. We're facing some real challenges. And it can be argued that right now we need social connection, more so now than ever. We're going to talk about the opportunities that are at hand. And so, I'm just so excited to have you meet these two individuals.

Mark Gomez, MD [00:09:12] So what we're going to do, of course, I'm going to ask questions. And we kind of called the chief complaint when somebody comes to our medical practices, why's somebody here? The chief complaint - the question of the hour, of course, is what are the hidden health dangers of loneliness and isolation? We're going to get into that. We're also going to get to a favorite section that I have. And I know you love myths versus facts that will come later down the road. And, of course, then we'll wrap some things up. So I'm so excited. We're going to get right at it. Let's get right into this.

Mark Gomez, MD [00:09:39] So the first question I'll ask to Dr. Kate Johnson. Here we go. First question, and this is more like just to help define some terms. So, what is, let's start with social connection before we get into isolation, what would you say social connection is? How do you interpret that?

Kate Johnson, MD [00:09:56] So you know where we are, as humans - social beings, we're meant to be kind of pack animals. Right. We're not we're not generally set out as a as a species to be the loners. Right. And so, we need, we have an inherent drive and inherent need to find each other. And to you know, those connections can be many different things. I think, in ancient Greek, I think there's like eight different words for love. Right. Which speaks to the variety and the subtlety and the just amazing spectrum of ways that humans can connect with each other. And so social connection, of course, obviously has come to mean different things, you know, over the years. Certainly, it's always meant like having your friends, having your people, your tribe, who you interact with. And then over the last couple of decades, we've really turned into a global community. So it can mean it can mean connecting with people on the other side of the planet, people that you know, with it, with the rise of the Internet, right, like you can connect with people who maybe have never met in person. But that doesn't mean you still don't have real connections and real relationships. So, it can mean many things right now.

Mark Gomez, MD [00:11:14] You know, I love that you said really on some of the origins even go back historically, I said at the beginning, this is innately human. It's been part of our human existence. I think, I get those images about, you know, our, the tribe, as you said, Dr. Johnson, where you had people that maybe gathered, they hunted, but you have this system, this connection, and it gave you the sense of security. As a matter of fact, I think the I think the most the only needs that are more important than a social connection are maybe our physical needs. Of course, as a species, we have to survive. AKA reproduce. We need air. We need food. We need water. And maybe some of our own security for a lot of us, you know, that's employment or a home or health. But outside of those two categories, social connections is so important. Dr. Wilson, when you think about social connection, just your interpretation of the word. What do you think it means?

Daryl Wilson, MD [00:12:02] Well, I mean, as Dr. Johnson was saying, it's it sounds so simple. It's almost like the simplest trope in the movie. Like, you know, what was lacking? Why did they die? It was because they didn't have love. And it sounds so cliché and so almost, you know, written by a fifth grader who's writing that paper. And then it's like they deus ex, everything. It's like and then they woke up and love was there. But that's kind of the whole thing. You have to have love, but it's more than that. It's feeling love, feeling cared for and feeling valued. I mean, I think that's the big thing, that people have to have a true social connection. It's your group or whomever around you kind of plays into the ability for you to feel valued. And when you feel valued, then you feel stronger. You feel that you have this ability that you can move forward, even during hard times, because now you feel like there's something that you can contribute to other things as people are contributing to you. So social connections have to do with you feeling valued. And what sometimes happens to break those things is individuals start making value judgments that aren't based upon reality, and that's where you can start breaking social connections down. But to make that connection, the person has to feel valued. So, feeling love, feeling care for, feeling valued, that's the key thing to social connection.

Mark Gomez, MD [00:13:24] You know, when I think about the biology of social connection, of course, you hear about something, I love I love to talk about biology. But like oxytocin, the hormone oxytocin. Maybe your hypothalamus secreted by the pituitary gland. It is called the love hormone. And that a hormone when you're involved in that kind of connection, that hormone becomes a very powerful part of your reward system. It works with other chemicals in the brain, other neurotransmitters like GABA and dopamine and serotonin that really give the body a reward circuitry. It's interesting researchers out of Stanford in the past or even at multiple institutions, they've found out that if you if you kind of eliminate oxytocin in mice, they don't want to, the mice wind up not wanting to socialize. So, it's kind of innately us that first human bond that we have when you're out of the womb and you're with your mom, but when you're with somebody, you start making those things. So, it's so just such a desirable thing, but the challenge is now, as Dr. Johnson really put, there's been a transformational shift in isolation and compounded by this pandemic. So, Dr. Johnson, give us give us a definition of social isolation and how this can really impact somebody's journey in health and in wellness.

Kate Johnson, MD [00:14:36] So think social isolation, obviously with the simple definition would be the lack of social connection. Right. And again, that very many different things. It doesn't necessarily mean that you're simply isolated, although it certainly could. But those connections start to break down or they become cut off for whatever reason. And I do want to interject here and say, people are allowed to be introverts. Right. It's not saying like, oh, we're social creatures, you need social connection all the time. But and I think all of us, even those of us who are clearly extroverts, have times that we need to recharge and be by ourselves. And so that's, I think, important to honor, too. But that's different than social isolation. Right. Having downtime or time yourself or me time, like those are those are different things than when you want those connections. When you're reaching for those connections, they've been cut off.

Daryl Wilson, MD [00:15:36] Right, and then add on to that, what Dr. Johnson is saying, I have to say, that's one of the things I think people have to really discern between. Like you can be amongst thousands of people and be the loneliest person that's there. You know, one is the loneliest number that you'll ever be. I mean, that's the key thing. But you look at, you know, this idea, it's once again going back to feeling value. You can have, you know, fame, fortune, all these things that you try to acquire to once again make people value you. And you can at the same time feel completely isolated socially because people don't value that. They look at you and they go, you don't feel like, hey, they've acknowledged that you've attained these things in some way to make you feel like there's value associated with it. So being socially isolated can be amongst a bunch of people. And you can also feel social connections when you're also by yourself.

Daryl Wilson, MD [00:16:33] Think about the people that kind of move into a city and they live on their own, but they feel the energy when they're out there, they're energized when they are amongst strangers, millions of strangers, yet they're energized. And then there are people who are celebrities who have people fawning over them who think they're the greatest thing since sliced bread. Yet they are feeling completely isolated socially, and then they become lonely and develop depression, anxiety, other things that then lead to them. People go, how could this person feel that way? They're famous. They got money, but they're not feeling valued. So social isolation is a is a total destroyer of people. And it doesn't have to be that person who looks like they are surrounded by the funnest people, the greatest people. They themselves have to have a feeling of value. And a lot of that has to stem from internally feeling value yourself to say I am worthy of value in some sense.

Kate Johnson, MD [00:17:32] Absolutely.

Mark Gomez, MD [00:17:33] Absolutely. Dr. Johnson, would you say like isolation? When I think of it, I think of it as, you know, social. But a pure definition, I think of social isolation as a physical state versus loneliness is more of a mental state. Are there any differences between the two? And I might even throw this in there, too. What about solitude? Solitude, part of that thing that continue or is that something different?

Kate Johnson, MD [00:17:59] That's a fair distinction. I think, again, going back to what I said earlier, I would define solitude, and I don't know what Miriam Webster would have to say about this, as that sort of like that time that you choose to be by yourself, that time used for internal reflection where you're not, it's not necessarily that your social connections don't exist, that maybe you're not engaging them in that moment. Right. And that's a good, so that's a good point, though, about social isolation versus loneliness. I feel like social isolation and physical isolation are not the same, though. Right. Which is a little bit of what we were saying before. I think it's more that you don't necessarily either, again, those social connections get cut off and maybe that's by distance. Right. Or lack of means to communicate or whatever, but that you're or you're just choosing not to engage them. Right. Loneliness, on the other hand, I think is that that mourning of those social connections. Right. So, you either don't have them or you don't engage them and you're feeling that that loss, that vacuum of it. Right. Not just in the sense of like, oh, I wish I had somebody around me to talk to you about the weather today. But just that that feeling of being alone and not having that thing that you want and just not having the hope of it, of it coming back soon. Mark Gomez, MD [00:19:35] Would you say, Dr. Johnson, on, maybe Dr. Wilson can chime in some, would you think like say, you know, somebody gets somebody gets a romantic break up, they get cut from a basketball team, you know, they get you know, you're not in a certain social circle anymore, is that loneliness or is social isolation?

Daryl Wilson, MD [00:19:53] I mean, I think that's social isolation in some sense that comes out of that, that can lead to loneliness, if you continue to feel that you're not valued. Say you find all of your self-worth in being that person on the team and now you're suddenly cut and you haven't really thought about other things that you can explore that give you a sense of value. Now, of course, that may lead you to feeling lonely because now you're like, I'm isolated, now I'm down in the dumps and I can't pull myself out of this because the spiral comes back to I'm not valued anymore. My value is based upon this one thing that I can do. And people being by themselves usually can find other things that they may find they are interested in.

Daryl Wilson, MD [00:20:38] If somebody goes my values based upon X and now I'm cut off from X, they're socially isolated from X.

Mark Gomez, MD [00:20:45] Certainly. Daryl Wilson, MD [00:20:46] And they become lonely. And you mentioned something earlier, you talked about physical isolation and social isolation correlating between one another. And I agree with Dr. Johnson, I don't think they can correlate 100% to one another. Being physically isolated from individuals may not cut off that social connectedness that you have with people. I mean, think about how people use technology to still engage with individuals. I mean, my family and I, we speak to my mom and my stepdad almost every day via using FaceTime. And even though my mom has not left the house, she's not left her house during this pandemic except to go to her doctor's appointments. You know, really, it's like we it's like we're never really disconnected from them in any way. And she still has great spirits because of that, because we know that she gives value to even seeing the kids running around dancing to Lizzo or something at one point or, you know, jumping up and down and showing the artwork they did from being here at home, doing school, all those things that still bring a connection because she knows that, well, they feel valued by her and she is valued by them. So even though they're physically apart, it's not that they have this social connection that's broken. But if you put those, you know, solitary confinement as a prisoner in a place where there's already you're devalued because you're beat down because society, says you're the worst of the worst. You are isolated away from your family and friends. You are now put into this place where you're still treated like trash. And now we're going to put you in solitary. That's when people lose their minds, because now there's no connection to anything, even the social group that you may end up with in prison, you know, that may give you value to say, hey, you know, yo, you are the guy that gives me cigarettes at times. That's good. And now you're away from that? Boy, that, people lose their mind. It's cruel, unusual at that point.

Mark Gomez, MD [00:22:41] It really is. And you mentioned about some of these barriers. And let's talk about some of these barriers, because that's a great example there. Let's talk about some of these barriers, because there's a certainly a perception, as we've been in this pandemic for the last year, that it's hard to maintain good social relationships. And as such, the pandemic has forced our hand to actually become more isolated and disconnected. So, let's talk about some of the barriers. Dr. Johnson, what kind of barriers, when you're thinking about your patients that you're working with that maybe have been really struggling during this time, what kind of barriers are you finding out that are there that are that are preventing people from being more connected and as a result, being more isolated?

Kate Johnson, MD [00:23:23] So, I mean, I think we all know there's a ton of things in the way right now. One of them certainly is physical distance. Right. And also just the change in our routine. Like, I know one of the things that I that I miss that I don't know that I ever realized that I would, is just the small talk at work. Right. Like, you know, running into people in the hallway or my residents kind of dropping by my office or, you know, just kind of catching up with people on what's their day been like what's on the fly. You know, whatever. Right. Our routines are all disrupted. We're missing kind of those smaller interactions. And then there's a variable access to technology or facility with technology. Right.

Kate Johnson, MD [00:24:09] When we when we flipped over to doing telehealth was like we have, we have some less technologically facile people in my department and getting them to just to just engage with the technology the video technology and figuring out how to use it and then the nuances and the comfort level with it. And everybody has a different level of that. Right. And then. Right, there's this whole other piece of, we're all tired. Right. And there's Zoom fatigue, I mean, staring at a screen all day is exhausting, mentally exhausting and physically exhausting in some ways. You know, we've, especially early in the pandemic when everything was just chaotic, and we didn't know what was going on. Were we all going to die? And, you know, like all of these things. Right. Or certainly as the pandemic has progressed, it's worn a lot of us down and then we've hit. You know, the other thing about this past year has not only it's not it's not just that we're living in a pandemic, it's that we're you know, we've got just this social tumult and sort of political chaos and various things going on that takes a lot of energy. Anxiety itself is exhausting. Right. And so, the less you have to pull from that, then, you know, all of the other things that you have to give it to you. Whether you have people in your household who, you know, we're now we're all on top of each other and we're driving each other crazy. You know, all of this stuff just adds up. It adds up and it takes what energy you have. And so then now we're faced with the conundrum that we're all tired. We're all like really on edge, and worried, not really wanting to feel vulnerable. And now we have to take that much more energy and put that much more effort into the connections that we would just have had normally in the course of the day. Right.

Mark Gomez, MD [00:26:05] It's interesting, Dr. Johnson, you know, you're spitting the truth on that one. And I think of it, when I'm seeing patients in my practice and I do find those scenarios of isolation, me being an internist, and thinking about lifestyle and stuff and trying to find some, well, see if there's a silver lining anywhere in things or an opportunity. You know, I can't help but not to think about the more the hidden dangers, the physical manifestations that can happen. And they end up in the E.R. and Daryl and Dr. Daryl Wilson's E.R., you know, things like we know that isolation can lead to heart disease. As a matter of fact, some cardiovascular researchers say that having social isolation is equivocal as hypertension, as a risk for heart disease. So, you're seeing rising heart disease. In the lifestyle medicine world, we say this, there was a landmark study that was done in 1979 that looked at a population out in California and looked at, it turned out that in people, mainly men, men were 2.3 times more likely to have an earlier death, if they did not have a good social connections and in women 2.8 times likelier, higher likelihood of having death if they do not maintain adequate social connections. When you look at the blue zones, which are the parts of the earth where people live the longest, it turns out that when you have that kind of connection, we can see some of the data showing that it can extend life by 7 years. And that's a term called the Moais and Moais are originally from Japan. And it's really the social connections, it's really a community. And what happens in Japan, of course, Okinawa, which is one of the blue zones, people there live in highest, one of the highest concentrations of centenarians on the planet because they've nurtured social connections from the beginning. So, let me ask Dr. Daryl, what's in this question, if somebody doesn't have an environment, I just dropped this term, Moai, spell it everybody M. O. A. I., I got it. Look it up, Moai. Dr. Wilson, if you don't have that community because we all can't be in Okinawa right now trying to live to be 100 years old, we're here, the USA, and we don't have the community when we know that the U.S. is, our country has become more fragmented, a lot of different issues going on, where can somebody find that silver lining as far as connecting and knowing that they can overcome some of the potential health complications?

Daryl Wilson, MD [00:28:19] See, that's the hard part, because you find there's a double-edged sword for that. Sometimes people retreat to social media to try to find ways to meet other individuals that may be going through what they're going through to have, hey, you know, misery loves company and we can now have other connections that way, connected with family, connected with friends. But it's a double-edged sword. In one way, you can use it to kind of cut through all of the things around you that are inhibiting your ability to have social connections but can also cut them off. And so, you know, it's that whole idea that there's a, it's human beings. You know, we have come through stressful events, stressful activities and learned how to manage those things. Think about, you know, I can go back to when I was in high school and the ability for someone to deal with some of the social ills that would hit you at that time. And you had to confront them in a way that was, hey, head on and how do you move on and move on to these things? Some of us didn't do very well of that, but we learned how to work that through. Yet now individuals can almost retreat into this social media world, whatever medium they're going to use, and use that as a security blanket to kind of not actually then deal with in the real world the problem that's in front of them.

Daryl Wilson, MD [00:29:45] And so that can lead to even more social isolation, unfortunately, as you go into this world. And then suddenly you're in the world and you're looking and you see that all of your friends that are there are suddenly icing you out or they've canceled you and now you even feel more isolated in some sense. So, it's that double-edged sword of using technology to find ways. And the problem with that is to that access to technology or access to, say, high speed Internet and other things may not be equivocal across the board for individuals in marginalized populations where their stress already there because the pandemic may have led to you having an inability to work, as you typically would, or individuals in your family are actually physically ill with the disease process at this time, all those things can lead to even more sense of isolation as you feel that you are now iced out of the daily routines that people would go through, going to work for people was sometimes their social interaction. They had this common ground of, hey, we're all in this together, we're going to work. We've had the luxury of having to still go out to go to work because we're taking care of everybody during the pandemic. So, I've haven't had to have that kind of loss of social interaction from the workplace.

Daryl Wilson, MD [00:31:07] But think of people that used to have to go into an office building and work and then finding out you can work at home and they're working at home. And their interaction is through technology like Zoom, which isn't interacting as well as you typically could. But there's little small time, little small talk that you'd have about, you know, watching Game of Thrones before when it was on or watching this or hey, did you think, it's, you lose that and that, you know, tribe of the people you work with is gone. And that's a part of a lot of people's day. Now, they're stuck at home when they find out maybe they don't like the people they're with, unfortunately.

Mark Gomez, MD [00:31:46] That's that revelation.

Daryl Wilson, MD [00:31:48] You know, so, it's finding ways to use technology to your advantage. But sometimes it's also finding ways to, not be isolated, but finding ways to if you're alone, not feeling lonely and finding once again value in yourself. And where that comes from, maybe you suddenly learned more creativity comes when you're alone, more creativity can come out for individuals, ability for people to really reconnect with themselves and not have to please other people, which people do all the time. You know, those are things that I think that are bonuses that can come out of having time for self to become more selfish and learn more about self, that you can then, when you have those connections with people that you do are socially connected with, they become more robust and more valued in some sense. So, it is a time to almost reflect, to almost meditate in some sense to get yourself back into knowing who your self is, to then share of yourself to other people. And going back to the whole thing about the health care issues that occur in the E.R.. Yes, you know, there's been, it's been shown and look at, you know, some of the studies out of University of California and Los Angeles that Shelly Taylor did on inflammation and inflammatory markers that would increase because of, you know, stress. And these things are leading to individuals being more stressed by being socially isolated. That definitely is the marker for disease. We all know that. Inflammatory changes are the things that lead to disease processes occurring. So inflammatory changes in the vasculature, inflammatory changes all over. So we have to find ways to find value for ourselves and maintain those social connections that we have, even despite some of the barriers that are there, whether they be racial disparities, economic disparities, technological disparities, we have to find value in ourselves first.

Mark Gomez, MD [00:33:57] Wonderful. Dr. Johnson, let me change topics a little bit. Let's get into some of the mental health issues that you see. You know, what kind of diagnosis or what are the negative impacts, what are the mental health effects of social isolation? How are people presenting? What are the diagnoses that we see? Kate Johnson, MD [00:34:15] We're definitely see. And, you know, right now it's a little bit hard to kind of piece out, like what is the social isolation and what is the isolation, the physical isolation, touch and things like that. And also, just what is the stress of the times that we're living through. Right.

Kate Johnson, MD [00:34:33] It's one of my one of my OCD patients and who's always had this horrible contamination phobia. We have gotten to the point now that we're joking about like but now this is kind of normal Right. Like, I can't tell you not to wash your hands 83 times a day because that's what you got to do to keep yourself safe. Right. So, you know, fortunately, that patient and I can find a little bit of levity in the situation, but it's you know, it's so stressful to kind of navigate this new normal we've got. And how do you how do you how do you balance wanting to live your life but wanting to stay safe and not worry about all of those things, again, not only in a pandemic sort of light, but also in all of this, this social chaos that's going on right now and all of the you know, the things that have especially for, you know, for certain for certain populations, things have gotten more acutely unsafe with all of this going on. Right. So, having said that, we're definitely seeing a huge increase in anxiety, depression and substance use are kind of the biggest ones that I've that I've been coming across. Interestingly, there's also been a pretty significant post COVID effect that can put you at risk for anxiety and depression as well, which is also factoring into all of this. Right. But definitely, you know, those are big, big things I'm seeing. And I think there's a lot of factors in, again, how we're choosing to socialize. I think like Dr. Wilson, like you said before, social media is such a double-edged sword. I mean, it definitely can be a way to reach people and to connect with people. I will tell you; we have a one of the Facebook doctor groups that I'm in, we have a weekly Zoom happy hour. And that was a godsend. I mean, it's still great. But like at the beginning, right, when we were like.

Mark Gomez, MD [00:36:34] How do we how did Dr. Wilson and I join your group, by the way.

Kate Johnson, MD [00:36:37] Well, I mean, it's a women's doctor group, but I won't out you, so, you know, like at the beginning of the pandemic when we were all still trying to figure this out and everything was just it was scary and chaotic. And we didn't know anything about this this thing that was coming. And my colleagues in the ICU were having all of these horrible things that they were witnessing and certainly the E.R. psychiatry, everything's great. Right. Like that ability to come together from this social media group was invaluable for us. Right. The flip side of that is you're now comparing yourself when you're looking at social media, you're comparing your raw footage to everybody else's highlight reel. Right. So people start to make those judgments, like you said earlier, Mark, or not reality based, but they start comparing. They can start to devalue themselves. You know, you can sometimes end up in sort of an echo chamber of your own beliefs and that can drive some less healthy ideas and less healthy behaviors. You know, you really, really kind of have to watch what you're how you're using technology and how you're using social media, because all of those things, like I said, can definitely drive depression and anxiety. And then, of course, you know, when stress goes up, people who reach for those less healthy coping skills of substance abuse and things like that, that's going to drive this way up as well. That's a whole other issue we're dealing with right now. Right.

Mark Gomez, MD [00:38:13] Oh, again, we think of this as you know, I'm glad we have this conversation because, you know, we want to be able to help people. Of course, we help. We want to help as our nature being physicians, but support for us even as physicians to have these conversations and things that we might have had when we went and seen each other in a lounge talking about a case or things like that. So, we learn from each other. So, yes, we've been also resigned to having connections virtually as physician colleagues. And that's been had its ups and downs, too, because especially the connecting factor, that tribe. But also think about like, you know, as we talk about some of the challenges that are there, you know, we always think about what are some ways to get people to give them some hope. And I love the word. Both of you guys used that word as well. Are there kind of steps out there for people? Maybe somebody is naturally introverted, are there steps out there for people to try to enhance their social connections. Dr. Wilson, are you have any ideas on how we can start changing things?

Daryl Wilson, MD [00:39:15] You know, that's a good question, Mark. I think that to try to make change, the change starts with you. And that's how that always has to begin. To try to change the external things, right now, you can't change the necessity for individuals to avoid physical contact and to stay somewhat isolated away from others for because of the communicable disease that exists out there of COVID-19. And so the first things that we have to do when we're changing something to change it, how we feel or how behaviors are is reflecting on what things are here that need to then suddenly make some steps to go in a direction that I want to go in. If I'm if I'm anchored to I guess, you know, the feeling of my value comes from what other people say about me and I am only on a social media that allows people to comment and I see all these great comments, and then there's a bad comment, that could take a person who values what other people think about them so much, and it's going to destroy them no matter what all the positive comments are. And you get into that spiral that keeps on going over and over again. It's a negative feedback loop. But finding other individuals that are in that positive feedback loop, it kind of goes and it perpetuates on. It pays forward. So, finding social connections with individuals that are one, have value who can also instill value in some sense by example, I think is one thing that you have to seek out. And it's sometimes it's hard, though, to find that in your local community because you can't physically find people all the time to do that, you know, so so do you find it in one, reading and finding books that you can do that are self-help, meditation, taking up a hobby in the sense that you've never tried before, you know, taking up art, learning to play music, you know, learning to treat yourself and say, I'm valued, I'm going to treat myself. You know, I'm by myself. I'm a treat myself. I don't got to I don't have to apologize to anybody for, you know, buying these, you know, that that number three, you know, Black Panther appearance in Fantastic Four. I don't I don't I don't got to apologize for that. That's where people have to then start looking at, you know, the things they can do for themselves that allow them to then say, I'm feeling a little bit more confident and strong. But once again, not to just throw that out there, because it's sometimes hard when you feel that there's weight that's on top of you that's not lifted off of you. And you might need a little assistance from the outside to get some help. When people say lift yourself up by your bootstraps one, you've got to have some boots in the first place. And, you know, if you don't got those boots and if somebody is telling you, like, hey, just do it yourself, I get that. I'm saying that in a sense. But I'm not saying that at the same time, you also got to be willing to reach out and ask for help.

Kate Johnson, MD [00:42:33] Absolutely.

Daryl Wilson, MD [00:42:34] When you have that. And finding professional help sometimes is super important to realize it's not some stigma that you to go this is bad. No, it's good. Reach out and get assistance. Get help. That's the first thing you got to do. I need help. Go get some help.

Kate Johnson, MD [00:42:50] I tell my patients all the time. Right. Like if you if you were a professional athlete, of course you would have a coach, you would find the best coaches that you would practice over and over and over again. Therapy's, the same idea, right, like you're finding a coach in the sense toward being at the peak of your mental health. Right. And that obviously can also include your psychiatrist, which might you might think about again, again in this sort of athlete example. Right. You're going to want your the top orthopedist or the top sports medicine doctor. You want a top coach and then you are just like headed for the Olympics. Right. I mean, I don't there aren't therapy Olympics that we should be. So, it's the same idea, right. Like, you know, for things like that, you wouldn't hesitate to get a guitar teacher to learn how to play an instrument or specifically guitar or hire a Spanish tutor if you were if you were learning a new language. Right. Like, this is this is what we're trained for and this is what we do, you know, we get you to the to the top of your game.

Mark Gomez, MD [00:44:00] You mentioned, both of you mentioned about connecting with people that have positive positivity as well. You know, we call those, you know, people that have a high emotional carrying capacity, people that can have setbacks, not afraid to have setbacks along the way, but they're able to still give it, give it, give them all that sense of positivity is attractive. Going back to that oxytocin, oxytocin, it's something that people want. And so, surround yourself with people that have that positivity, the confidence, the feelings that can give you a feeling of vitality and aliveness. I love the word aliveness. I don't even know if that's a word alive, aliveness. Kate Johnson, MD [00:44:38] It is now. Mark Gomez, MD [00:44:38] It is now. You heard it on Health 360 with Dr. G. Aliveness is a word, but what I'm saying, I don't think I even know what I'm talking about. But what I'm saying, you guys you guys feel you know what? It's all good. But becomes.

Daryl Wilson, MD [00:44:51] I think I'm going to start using that every day.

Mark Gomez, MD [00:44:53] I'm going to start. We got to start using it tomorrow. Be like Dr. G said aliveness.

Kate Johnson, MD [00:44:57] Aliveness.

Mark Gomez, MD [00:44:58] There's this doctor that said aliveness. And it's all good. Hey, you know what, sense of levity. I would say, you know, if it sets a tone, it's like it's like the tone when you're singing car karaoke or you're singing shower karaoke. Yeah, but again, it helps us. It sets a tone. I love pets. Pets are a great way to find connection. And actually connecting with others that are pet lovers, too, might be a start for somebody who might be introverted as well.

Daryl Wilson, MD [00:45:26] Think about that. I mean, think about that the, you know, increasing adoption of pets. I mean, we just got a new dog. Our dog died a year ago.

Mark Gomez, MD [00:45:32] I saw it on social media, Dr. Wilson. There you go.

Daryl Wilson, MD [00:45:35] Yes, got a new dog. And, you know, the thing about having a pet that gives you value again, because now this this living thing relies upon you to, you know, feed it, to bathe it, to walk it, to love it. And it gives you back that love. I mean animals, you can be your worst day. You walk in. I can come in from a shift and it's bad, and I walk in and the dog's just wagging their tail and you can't there's no way that you can actually continue to keep that dour, you know, feeling it's like it just melts away. As soon as you pet that dog, it's been shown, you know, you start releasing oxytocin your blood pressure goes down. It's like all those things that you are living well because so the idea of caring for another living being that then has to rely upon you is is a true value right there. You become valuable to that creature that relies upon you to make it survive as well. And then they give you back that unconditional love and support up on your you know, then they tear apart your stuff and they pee in your house.

Mark Gomez, MD [00:46:44] Well, on that note, let's get into some myths versus facts, y’all. l love it. And we're having this great conversation. We're talking about hidden health dangers of loneliness and isolation. Myths versus facts. Here's what I'm going to do. Those of you that have followed Health 360 with Dr. G, you know the routine. I say the statement and my awesome panel says myth or fact. We're going to try to get those videos we can on this one. I actually might participate this time, guys. I don't know. I mean, you guys know me enough. We'll see what I'm feeling. So, the first statement goes, myth versus facts. Here we go on hidden dangers of loneliness and isolation. First question. Question? What am I saying? Statement. Dr. Johnson. Here we go. Statement. Yes, here we go. I like this one. Social connections are as important to a person's survival and vitality as food, shelter and safety. Myth or fact?

Kate Johnson, MD [00:47:34] Maslow might disagree with me. I think social connection was like the second or third tier. Right. Like I think, you know, food, water, probably more physically, physiologically necessary. Shelter is really very important. But, you know, like we kind of alluded to before, like a lot of the ways that we create our safety that we create, you know, that that ability to, you know, like if it's if it's just you by yourself defending against the elements or the woolly mammoth or the whatever. Right. But if there's two of you, you're twice as strong. Right. And you, in fact, are probably better off and woolly mammoth fight. I don't know where this analogy went.

Mark Gomez, MD [00:48:18] I come up with analogies, you're coming up with your analogies, it's all good. This is what we do.

Daryl Wilson, MD [00:48:24] I feel aliveness on this. I'm here with aliveness on this.

Mark Gomez, MD [00:48:28] Aliveness. Y’all not going to let me live that down.

Kate Johnson, MD [00:48:31] No. Never.

Mark Gomez, MD [00:48:32] Aliveness again. Never live that down. You like it? Aliveness.

Daryl Wilson, MD [00:48:34] Aliveness.

Kate Johnson, MD [00:48:35] But I do think, I do think and that's part of how we create a lot of our safety and we get our resources in about in a more efficient way. And I think, just especially in a society where we can just go to the grocery store, we don't have that, we don't have things and fight woolly mammoths. It is it is as essential as anything else.

Mark Gomez, MD [00:48:58] I got you. Here we go, Dr. Daryl Wilson, myth or fact. Here's a statement. It is easy to stop self-isolating. Myth or fact?

Daryl Wilson, MD [00:49:07] Oh, geez. I think that's a myth.

Mark Gomez, MD [00:49:11] Please explain that.

Daryl Wilson, MD [00:49:12] Well, so to stop self-isolating, you know, the problem is it kind of builds on itself. It becomes this kind of perpetual motion machine that keeps moving. So, once again, like I said, it comes from you feeling devalued. So, if you continue to have those hits, there was a, who is it, the doc? Ethan Cross, University of Michigan. There's like when you have a hit that hits you, that devalues you, it causes the same areas of the brain that perceive pain to activate. So that right there is continuing to hit you. So, it's hard to get out of that cycle. You can, but it's not easy. It's like the plane's going down. You have to find a way to pull up before it crashes, because if there's continued hits to that isolated feeling that you have, it does then lead to loneliness. So, it is a continuum. So, it's not easy, but it's possible to do. It's like lifting a heavy weight.

Kate Johnson, MD [00:50:13] And I think, that's a really good point. Like, I think, we all kind of have to go back to, like second grade for this sometimes too. Right. That you have to you have to be a friend to make a friend. And I think it's especially if you're kind of in that loop, it's really easy to be like nobody's reaching out to me. Nobody wants to deal with me. Nobody wants to hear my problems, all of those things. But then again, yeah, no, nobody is. Everybody's kind of wrapped up in their own stuff, too. But if you can reach out, people will start connecting with you a little bit more. You know, you don't want to be the one carrying the whole relationship, obviously, that's a whole other kind of dysfunction. But you have to remember, you want to reach out to people, you want to listen to actually hear and understand instead of just responding like you, you need to be present in those connections as well and they'll blossom.

Daryl Wilson, MD [00:51:03] And the social isolation part to get out of it sometimes. Sometimes social isolation is brought upon you for factors that are sometimes outside of your control at the time. I mean, think about a person who is specifically, you know, say you're the only African-American person in a town and that's you feel isolated at that point because you've not had those connections that you feel are so deep seated that have given you value. And then you're like, once I get out of this town, I'm going to go to Howard, I'm going to do this. And then you have this whole other, you know, rebirth and this whole thing where you build that back up and say, wow, now you feel connected in a way. So people have found ways to one, they feel socially isolated for a long period of time. But they've always had this plan of I'm going to get out of here. That's always the thing. I'm going to go someplace else and find a connection because I know it's going to be where I'm going to find myself so that those are opportunities for that. But it's not easy. So that's why I think that it's when you ask me that question is easy to do. So, I don't think it's easy. It's possible, but not easy.

Mark Gomez, MD [00:52:04] Here we go. Dr. Johnson, I like this one. Myth or fact? Here's a statement. Social isolation only occurs in elderly individuals, myth or fact?

Kate Johnson, MD [00:52:12] No, that's just.

Mark Gomez, MD [00:52:14] Please explain.

Kate Johnson, MD [00:52:16] Social isolation can occur at any at any life stage, at any age. Certainly, the elderly can be more prone to it for a number of reasons. Right. Again, physical, physical isolation, not necessarily being able to keep up some of the connections they've had, et cetera, et cetera, just like changing whatever. Right. But it certainly can happen at any age and any phase of life.

Mark Gomez, MD [00:52:44] Well, thank you. And I might add, there is some data out there that shows that in our elderly population being social isolation can actually accelerate cognitive decline. And so, it's also a loneliness as well, too. So, it's important to maintain those connections as we continue to get older. But thanks for clarifying and saying that's a big myth. Dr. Wilson, I like this statement. Myth of fact, technology makes us more alone. You like how I give you like tough ones.

Kate Johnson, MD [00:53:14] I appreciate you giving me the slam dunk.

Daryl Wilson, MD [00:53:17] Makes us more alone, you know.

Mark Gomez, MD [00:53:19] Philosophical. These are philosophical myths versus facts.

Daryl Wilson, MD [00:53:22] That's as you know, technology makes us more alone. That is a myth fact. So, the thing is, how.

Mark Gomez, MD [00:53:34] That is a first on Health 360 with Dr. G. Myth Fact. Go ahead, please go. Love it.

Daryl Wilson, MD [00:53:39] I mean you've got aliveness.

Mark Gomez, MD [00:53:41] Aliveness. Aliveness. Aliveness, y’all. Those of you that never listen are probably like what are they talking about. It's all good.

Daryl Wilson, MD [00:53:47] I mean, the idea of technology making us more isolated and more alone, yeah, I mean, in some senses you can have, you know, a thousand people on, you know, a hundred thousand people on Instagram, they're going to watch you, yet you don't have any real connection to those people at all. They don't really give you a true value. You know, the value you get is usually instilled upon you earlier to give you that self-esteem that you come growing up with because your parents are giving you some value. They could also mess it up at the same time too. So, technology can sometimes exacerbate the feeling of aloneness. Does the technology necessarily make you feel alone? I don't know if that's the truth. I think that they can just kind of increase it in some sense. You have to come into the feeling of loneliness because you've already felt socially isolated and then you go on to your social media things. And once again, you're looking for value, someplace where there might be false, you know, value put upon things. So, if you break from technology, can you go off and live in the woods and, you know, communicate with the bears and then you're all going to be feeling better? You know, that might be the thing. Taking a break from some of these things can help you to at least come back to reality and look around and realize the sun's still shining. There are people that truly do love you and are really giving you value that are here. And those false people that are haters that are online aren't really there. So, I guess it can grow. It can make your feelings of aloneness become more real to you. I don't think the technology itself does it. Technology is not sent in. It can't do that to you. You have to allow it to do that to you in some sense.

Kate Johnson, MD [00:55:32] Technology is a wonderful distraction if we get in that manner. Right. And sometimes that's OK. Let me tell you, I would not have gotten through this pandemic nearly as well as I have without the discovery of TikTok early on. And so, like five minutes of just like watching puppies play and various people do some silly things to sort of have a reset and then I get on with my day, great, very good. But if I'm using technology in a way that I'm like putting all my energy and taking all the stimulation and not settling to a point that I can deal with everything that's underneath it, that's not helping.

Daryl Wilson, MD [00:56:13] Exactly. That's it. It can't be your security blanket. It cannot be your security. If that's your security blanket, you suddenly retreat into this fantasy world and the fantasy world turns on you. You've got no other place to go. You have to have it. You can look at it from the fun in the kitsch of it, but to take it for that, that value that face value is real, that real value, you have to be able to turn it off and go do something else. You have.

Kate Johnson, MD [00:56:38] Speaking of puppies playing, I'm really enjoying watching your dog.

Mark Gomez, MD [00:56:42] Dr. Wilson, your dog is in the background like, going back and forth, I love. Great observation, Dr. Johnson. It's that oxytocin effects. Get me some oxytocin, y’all. Hey, let's do one more myths versus facts. This one's for Dr. Johnson. Here's a statement.

Kate Johnson, MD [00:56:55] All right.

Mark Gomez, MD [00:56:55] This has kind of been in the news quite a bit, but at least we didn't talk about it too much during this podcast. But let's go ahead and just try to maybe clear some air. Here's a statement. Social isolation can lead to increased suicide risk for young people.

Kate Johnson, MD [00:57:09] Absolutely true. And again, I think it has to do with that that piece where you just get into that negative self-talk loop and it just gets reinforced and reinforced. And as those connections, like I said, now we have to work a little bit harder for some of those connections. And as you don't have the energy to do that as the as the voices and I mean, those as figurative voices not that's a whole other issue, if they're real voice, those that self-talk loop of like I'm not I'm not worth it. I don't deserve it. I don't people don't want to be around me as those things start to perpetuate, it definitely can lead down a very dark path. So, and that's true. It's not just for young people, it's true for adults as well. Again, any depression does not discriminate by life stage or socioeconomic status or any of these things. This can occur for anyone. And I will also say there has been some interesting stuff in the news lately about school systems in California that noticed their rate of youth suicide going up and so are working very hard to getting back to hybrid or in person.

Mark Gomez, MD [00:58:23] Now Las Vegas as well too.

Kate Johnson, MD [00:58:25] Yeah, and well, I think that's reasonable. I also think there you know, there are school systems that are doing a great job of keeping with students from feeling socially isolated and doing those things. And so, I don't think there's one clear path. I know plenty of students when we were in school full time before any distance learning stuff started, who felt socially isolated. We had one of the schools where I have a clinic, we had a rash of suicides a couple of years ago like this is that this is a common problem and it's not necessarily just contained to this situation.

Mark Gomez, MD [00:59:03] Well, thank you, Dr. Johnson. So, hey, everybody, we've got about five minutes left. And this has just been I mean, we can we can be talking all day about this, but it's important that we're having this conversation and making sure that you are out there listening to this conversation and hopefully applying things are looking at things a little bit differently. Another perspective on how you're approaching your day to day for you and your loved ones. So, what I want to do, I talked at the beginning, the chief complaint was again, what are the hidden dangers, hidden health dangers of loneliness and isolation? We call it the chief complaint at the end. We call it the assessment of plan. That's when somebody comes into your office after you've examine them and done everything, you render them a diagnosis and you give them a treatment plan and most importantly, a follow up. There you go. That's right. So, let's break it on down. We've got a couple minutes left that. I'll start with Dr. Wilson. Dr. Wilson, give us a few take-home points for people that are out there listening to us today on this conversation. What are the next crucial action steps for people to take? We're talking about be more aware of the hidden health dangers of isolation and loneliness, but also the opportunity that's at hand.

Daryl Wilson, MD [01:00:05] So the one thing I think that people need to understand is that there are physical disorders that come out of this from the standpoint of the increased risk of cardiovascular issues, you know, increased and, of course, increased morbidity and mortality associated with just your regular disease processes that you have to begin with. If you already have chronic disease, things get worse at this point. So, the first thing that people, I think, have to do is put a plan together is to we have to stop devaluing each other. I mean, that's what we've been doing more and more. It becomes easier with that double-edged sword of social media to try to devalue people very quickly. When you hide behind a keyboard, you can actually state any statement that you want that can be false or completely overblown and speak in hyperbole in hyperbolic ways of speaking. And I think people have to realize that we can't devalue our fellow human beings. We have to start looking at, hey, giving people a little, you know, a little pub and pull them up and when you pull some people up and they start to pulling themselves up a little bit. So let's stop devaluing each other, first of all. If we can start doing this and give a positive word to at least somebody once a day, they'd be great. You know, call your family members, call your grandparents, call people up and let them know that you're thinking about them and that they're important to you. That's super important stuff. Tell your colleagues that when you get a chance to see them, just, you know, just a simple word of encouragement is pretty, pretty powerful at this point. And with that being said, you know, also learn to value yourself. When you have those moments where you are alone, don't feel that you're lonely, you know, and it's hard to just say don't feel lonely. I'm not trying to say, hey, that's not the way to go. Just realize that sometimes it is a time to reflect, to recharge, to find, you know, you're to treat yourself and do those things. So, so, so finding ways to, one, value other people and really value yourself. And those are the simple things we think about it. Go out and do this. You've got to still do the simple things of eating healthy and, you know, and trying to keep yourself physically active as best you can. But you can't, you know, take away the need for social connections being a super important part of that trifecta of things that can lead to you having better health, great health, longevity. Was that aliveness.

Mark Gomez, MD [01:02:39] Aliveness. You heard it on Dr. G. Health 360 with Dr. G.

Daryl Wilson, MD [01:02:43] And that's no myth fact right there. That's a fact.

Mark Gomez, MD [01:02:47] That's a double fact.

Daryl Wilson, MD [01:02:48] Right. Mark Gomez, MD [01:02:49] Well, thank you, Dr. Wilson, for breaking it down and giving us some actual points out there. Really helping out. Dr. Kate Johnson, give us a few take-home points again for people out there. They're listening to us having this awesome conversation. But how can people take those next important steps when talks about overcoming the hidden dangers of isolation and loneliness.

Kate Johnson, MD [01:03:13] Sure. Yeah. I mean, on a practical sense, I. I give out the same advice that I give when we're not socially distant or physically distant, you know, find something you like, go do it. And maybe you find a, you know, a Zoom class or a Zoom or whatever. Right. Winetasting, exercise class. Find a Facebook group about, you know, people who like cats or knit things or whatever. Right. Whatever it is that that you like, find those people, you're going to make connections. You're going to find people you like that way. Right. On a somewhat more esoteric note, I think the one thing I really wish we could all do a little bit more is, is learn how to listen again, listen to understand. Don't listen to respond. I think right now, more than ever, there's you know, there's a lot of divisiveness. There's a lot of polarization in our society. And I think that starts to melt away when we get to know each other. And if you listen to people and you hear what they're telling you, then you start to know who they are. They start to be more complex to you. You start to make connections and you start to come together. Likewise, listen to yourself, listen to understand, listen to what your body is telling you. Listen to what your heart is telling you, because at the end of the day that that connection is going to be so much more meaningful if you're connected to yourself first.

Mark Gomez, MD [01:04:33] Wonderful. Well, thank you, Dr. Johnson. I'm going to thank my guests, Dr. Daryl Wilson, Dr. Kate Johnson. Before I give my health, my final thoughts, I want to do a quick shout out here. Listener Healthy OH-Yeah! content. Here it is. This is from C.C. Here's what C.C. says.

Mark Gomez, MD [01:04:49] I lost nearly 100 pounds by changing my diet adding exercise in my life. Not only did it benefit my physical appearance, but it also increased my mental health as well. Congratulations, C.C. I know I can say I'm with you. Dr. Wilson's with you. Dr. Johnson's with you. Being part of your village, I know you have a tribe and your tribe is supporting you through thick and thin. So, here are my final thoughts. You know realize that a sense of belonging is our most human needs. It satisfies those most human needs. But know that people often need a connection, whether it's a physician, a fitness expert, a coach, a nurse, a mental health expert, those people that are there for you will help you in your time of need. Also, don't forget about your family members or loved one or friend who is there to support you on your journey of health and wellness. So, when it comes to overcoming the hidden health dangers of isolation and loneliness, really it is our human connections, our healthy connections that can help us sustain healthy lives. So, I want to think again Dr. Kate Johnson and Dr. Daryl Wilson. It's been awesome, guys. It's been awesome checking you guys out. Thank you again for coming out. You've been listening to and watching Health 360 with Dr. G, a healthy driven podcast. This episode is written by Mark D. Gomez, MD and Tiffany E. R. Gomez. Producers are Tiffany E. R. Gomez and Sarah Zwack. Audio and Video Production Specialist is Mike Pasky. Copyright 2021 Edward-Elmhurst. All rights reserved. For more awesome health information, visit me at www.Health360Podcast.com and follow me across all social media @Health360wDrG.

Mark Gomez, MD [01:06:25] Hey y’all, this is Dr. G. signing off and until next time, peace out. Aliveness! Take care, guys. See ya.