Latest / College Is Fine, Everything's Fine / #89 Why Quick Fixes Are Making College Stress Worse (And What Actually Works) with Dr. Jill Grimes
Transcript
- College Is Fine Podcast: Okay, all right, hi listeners. We're talking about something that literally I just left a session with a college student, freaking out about midterms and about their anxiety, about tests that are coming up ⁓ and ⁓ they sleep all last night. hello listeners. I cannot believe we've made it through another Sarah ⁓ Sarah: my gosh. No. ⁓ and it really gave us a doozy towards the end there with a lot of technical glitches. ⁓ how many emails and psychologists does it take to switch ⁓ hosting studios. So ⁓ but we ⁓ yeah, so we're wrapping up ⁓ last episode a little bit later in the season than we're used to, but it was such a great interview. We just knew we had to get it out there. College Is Fine Podcast: Really was talking about ⁓ asking me ⁓ what my thoughts are about melatonin, which ones they should take, ⁓ how much they should take while they're dreaming so much, waking up with nightmares. Right. So we have somebody that I'm hoping is on Speed Dial and still a practicing family physician for when my own children go to college. we have Dr. Jill Grimes. And if you're a college student or a parent of college student, I'm sure she has come across your social media. ⁓ And she's gonna talk about ⁓ the ways that college students ⁓ sometimes manage the stress spirals they themselves in that are often And I like to remind my patients that I am a doctor of feelings, I am not a doctor of medicine, and that we really do need to outsource to an actual physician about what's really happening in the body, the relationship between our anxiety and sleep, ⁓ and maybe why college students are feeling so much pressure to fix these problems with solutions that I don't think are helpful in the long term. Sarah: Mm-hmm. Yep. College Is Fine Podcast: Quick fixes, but in the long term might lead to you not having the college semester you thought you were going to have. We found a very popular resource online. mean, social media presence. I have so many positive judgments of we have. ⁓ and a book. Yes, yes, yes. The Ultimate College Student Health Handbook. Your guide from everything to hangovers. ⁓ my goodness. And homesickness, which I love because a lot of people don't talk about Dr. Jill Grimes. So, Jill, introduce yourself to our listeners. So happy to have you. And on that note, in terms of more resources that we're going to be providing to you guys, we have some exciting news. Sarah, do you want to share it? Jill Grimes: Well, I'm delighted to be here. So I am a family physician. I'm a mom of two daughters that are in their twenties, but they are out of college now. But I keep my finger on the pulse with my college doc advisory board. I have a group of current students, 20 students from across the country, and we meet once a week. And so I am very much up on what's new and happening. Sarah: Yeah, so speaking of people who have perhaps been have had a lot of stress, more so that they anticipated during their college years. Liz and I wanted to remind you that while we love doing this podcast, our real true love is working with people. and so we wanna offer this summer some ways to connect with people who might need a little bit more than a podcast episode sent to them by mom and dad or something, that we wanna offer a a reset. Yeah, I think that having that sense of what's going on on the front lines is it changes all the time. So that idea, I actually didn't realize you did that. That's brilliant. ⁓ And I have to say, I know we're talking today about a specific area. And I love that you're going to be able to give us, even when Liz and I, again, talking to clients, they do ask us questions all the time. And it does make us feel like, OK, I know a couple of things, but maybe more anecdotally. ⁓ Jill Grimes: Right. Right. Sarah: workshop for those of you ⁓ if you're familiar with our REACH program and what that does or those guidelines you'll know kind of get a sense of what the workshop might entail. So we're gonna provide all sorts of details in our show notes about how to get in touch with us about that. You can reach out to me directly I'll be fielding calls but if you or someone you know felt like this past semester or whole year Jill Grimes: Sure. Sarah: And so Liz, I'm really glad that you kind of reached out and were able to find an actual doctor, as my kids would say. Well, you're not really a doctor. I'm like, fair. That's a fair point. You're right. I faint at the sight of blood. can I just say, this book, when I was looking through it, I wish I had had it in college. It is something where, right? It was probably why you wrote it. ⁓ And there's even things in here, like as I was flipping through, like, Jill Grimes: Yeah. Sarah: didn't quite meet your expectations or if you struggled to get across the finish line, then we would love to provide you some more one-on-one support, ⁓ you know, and offer some a bit more individualized care for this. So this would be in the form of a workshop or potentially some groups. There's a lot of different ways that Liz and I can be helpful for you in giving you ⁓ kind of the reach reset that you need. Jill Grimes: Yeah. Thank you. Me too. Yep. Sarah: ⁓ there's stuff about if you have a black toenail. I mean, you go through really all the basics. And it made me laugh so hard because when I was in college, OK, we can talk about periods here, right? That's not a scary word. I was in college. I had stopped having my period. And I didn't know why. So I went to the medical clinic there, like the campus doc. And I saw this young doctor. College Is Fine Podcast: Yeah. Yeah. Jill Grimes: Mm-hmm. College Is Fine Podcast: said said perfectly. So no, no, no no. Sarah: Want me to re s resay? And I said, I don't know what's going on. I stopped having my period. He's like, well, let's give a pregnancy test. was like, I haven't, unless it's the immaculate conception, it's not that. But OK, so test did not pregnant. And then he looks at me, and I'm not kidding when I say, he says, you kind of have a thick neck. Do think you could have a glater? And I was like, ⁓ I have so many. Jill Grimes: You're pregnant. What? What's wrong on 30 levels? Sorry, it's not funny. Sarah: I have so many. ⁓ like so I had a thick neck body just a specific thick neck body dysmorphia problem for like the next year anyway yada yada we did all these tests all these tests and I went back to get the results and the person who I was seeing which was an older female doctor goes everything's fine I'm looking at your birth control you're on a birth control that makes you not have your period we all hope you have a wonderful summer. ⁓ we will be taking our typical summer hiatus ⁓ and see you back in August, where we'll back to supporting you, ⁓ building you up and hearing more of your College Is Fine Podcast: It's just simple, simple. Jill Grimes: Hello. ⁓ Sarah: ⁓ So if I had this book, I probably could have looked in there and I would not worry about my thick goiter-like neck. And so everyone go out, buy this book, because you don't always have great doctors in the young clinics, right? Right? Get a backup. ⁓ So, all right. I felt like I'd share. So was really nice to meet you. College Is Fine Podcast: Enjoy your summer. We'll see you in fall. Jill Grimes: There you go. College Is Fine Podcast: Right, right. Jill Grimes: There you go. Nice to meet you too. I also had a challenging experience as a college student with an on-campus doctor, but let me just say, I did actually work in a campus clinic for seven years part-time, and honestly, my peers were excellent. So it depends. Sarah: ⁓ of course. Jill Grimes: where you are, but if you have a question about something, go back, get another opinion, see somebody else, 100%. And you guys know that that's true with therapists, that's true with across the board. College Is Fine Podcast: Right. Sarah: Right? Yeah. College Is Fine Podcast: Yes. Sarah: Right, advocate for yourself, trust your gut. It could be a lot of different things. Because I agree, every other interaction I had was wonderful. But it's amazing how the ones where they say you have a goiter stick out. Jill Grimes: Yes. Oh, yeah, I was told that I was grinding my teeth, that that was causing throat pain when I had strep and mono and 103 fever. So yeah, feeling your pain there. And yes, that is part of why I wrote this book, just to have better information out there. College Is Fine Podcast: Hmm. Sarah: Yeah, yeah. Right. But OK, I got us off track, so I'll get us back on track. Fair enough. ⁓ So we were talking about, though, academic pressure, which obviously comes at times where there's midterms and there's finals. And so that pressure is in the air. Everyone's feeling it. And then the things we start to see with that, Chronic stress. ⁓ Jill Grimes: Okay, all right, fair. Sure. Sarah: maybe not feeling as well as you should just overall health. So we think a lot about, you feel anxious, but what is actually happening to your body when you have that level of academic or test anxiety? Jill Grimes: you're basically putting your fight or flight hormones on overdrive. So your norepinephrine, your dopamine, your levels are just going through the roof. That affects your hypothalamic, pituitary, adrenal access, which nobody needs to understand what that means. What's important is that your body is on overdrive, right? And when your body is on overdrive, guess what? That decreases your quality of sleep and then decreased quality of sleep increases your stress hormones. And now we're in a big fat terrible cycle going the wrong direction. So it's super important to interrupt that. Sarah: Mm-hmm. Right. I think it's kind of helpful even if I can't say the word pituitary gland as quickly as you or I don't know what it does. Sometimes it's nice for me to say there are things happening to my organs. Like there's a reason I feel like this. It's not, you know, something that's wrong with me or I can't handle stress. Like my body is reacting. So it's a good reminder of like that bio and that's like that biology, I guess. Jill Grimes: We'll just say it. College Is Fine Podcast: You Jill Grimes: Yes. Right. Right. Yes, we can say HPA axis, hypothalamic pituitary adrenal axis. So your brain is talking to your adrenal glands, which sit in your abdomen above your, well, more towards your back, but above your kidneys. they, right, there we go. All good, all good, yeah. But you're right, I think it's really important to understand this is not just a it's in your head sweetie kind of thing. Sarah: HPA. I can say that. Mm-hmm. It's okay. No one's gonna do surgery on these. Mm-hmm. College Is Fine Podcast: Mm-hmm. Jill Grimes: It is in your head and it's in your body, but it is chemical reactions that are happening. And with all of that stress, you've got an increase in inflammation. You've got that chronic stress does people say, well, you know, it decreases your immunity. Well, what does that mean? And it's kind of hard to define. And the ultimate thing is that your white blood cells that, you know, are part of your body's immune defense. don't function quite as well with chronic stress, your inflammatory response is up. So if you've got any kind of autoimmune tendencies, you've got extra fatigue and joint pain and swelling and headache. again, all of these things feed on themselves and then they impair your sleep. And I try and emphasize, I think sleep is the most underrated priority in college students, I'm sure you would agree. And a tired brain makes everything worse. College Is Fine Podcast: Yes. Sarah: Mm-hmm. Mm-hmm. College Is Fine Podcast: Right. Jill Grimes: Right? That's my mantra. And because whether it's emotions or you you can't study as well, your executive functioning skills, can't plan to, you can't make your plans to study, you can't organize your time. You literally with a tired brain, you can't answer questions on a test as well. You can't problem solve, you can't memory recall as well. All of those things. So this is real neurochemistry and really important to understand. College Is Fine Podcast: Mm-hmm. Sarah: Right, well I know there's more recent studies that came out that said a tired brain, well my friend did the study, she's like, stop saying it gives you the munchies, it doesn't give you the munchies. But MTV and all the media kind of like spun it that way, right? But a tired brain also makes you crave, more likely to crave sugar and carbs, which then give, so again, it's like all of that, if you could just start with a good night's sleep, you get it done. Can I actually, this is something too that, I don't know that we had planned for it, Jill Grimes: All right, sugar, carbs. College Is Fine Podcast: Yeah. Jill Grimes: Right. Sarah: working a lot with people who've been traumatized, ⁓ you mentioned the immune system. And so one of the things that was explained to me, but not by a medical doctor, by one of my supervisors, is that at certain points, the immune response gets kind of heightened and strengthened, and then it's depleted. So you see, you go through stress, stress, stress, finals, finals, finals, and then you stop and everyone gets pneumonia. Is that true? Is that something to... Jill Grimes: Right. To some extent, we definitely see that with migraines. We always see post-final migraines, post-project migraines, right? Because it's that, you're right, the acute stress, and any acute stressor can heighten your immune response, but a chronic stressor depletes it. So I can't speak to the exact evidence-based medicine for getting a pneumonia after test. Sarah: Mm-hmm. Hmm. Mm-hmm, gotcha, okay. College Is Fine Podcast: Mmm. Jill Grimes: other than everybody's sleep deprived and doing all the wrong things. And so it does make you a little more susceptible. Sarah: Right, right. Gotcha, okay. College Is Fine Podcast: Well, I was definitely one of those college students that was chronically ill in college. And definitely due to, I think, this dilemma of wanting to increase alertness and wakefulness to study and then wanting to sleep, right? Which often kind of are competing ⁓ with each other and definitely at certain times during the semester. And so what I thought we could talk about a little bit is, you you mentioned most of these things. I think college students are looking for very quick fixes. Jill Grimes: Yes. College Is Fine Podcast: ⁓ usually related to procrastination, I would say some of the times, and also normalized on campus in terms of quick fixes. So maybe we can start with the desire for alertness and ⁓ ability to kind of like focus and narrow attention and talk a little bit about study drugs, which I think are quick fixes that a lot of college students are not really educated about the impact it has on them. But. Jill Grimes: Yes. College Is Fine Podcast: What are you seeing in your focus groups about study drugs? And maybe you can educate some of the listeners ⁓ about maybe why to steer away from that quick fix. Jill Grimes: Right, well I'm gonna start with a study drug that may not be what you're wanting to talk about immediately and the first study drug is caffeine. back in the day, it used to be No-Dose. Uh-oh, I see, I spy it. No-Dose was, yeah. Now, now you can drink No-Dose because all of these. College Is Fine Podcast: Mmm. Sarah: Aww. College Is Fine Podcast: No, no, those I have heard of no does. Sarah: No does I remember no dose. Jill Grimes: caffeine drinks are have insane Celsius, you 100 milligrams of caffeine boom right there. Yes. But also so so does Starbucks, right? I mean, you have to drink more and bigger. I know. I'm just saying. But yeah, yes, definitely, definitely CIP local. I summer moon in Austin, and San Antonio. College Is Fine Podcast: energy. Sarah: Ugh, it's scary. Shut your mouth, Dr. Grimes. No, I'm kidding. I'm kidding. Anti-Starbucks. Sip local. Sip local. Mm-hmm. Yeah. Laughing horse in Harrison, New York. OK, now let's move along. OK. Jill Grimes: All right, well, we'll put it, put in our plugs. anyway, so caffeine, caffeine is the first one. And I hate to say it, but nicotine, ⁓ this just makes me want to pull my hair out. The nicotine pouches have, are making a comeback, which is terrible. And, but they are, particularly with young men on campus. And it, they're exactly, zen. And so you're getting these, those stimulants. And then, then, College Is Fine Podcast: Mmm. Yeah. Yeah. Zen-ing, yeah. Jill Grimes: I definitely want to also talk about obviously the real study drugs, which are ADHD prescription medications. And the reality is that anyone looking for those on a college campus illegally, obviously without a prescription, it doesn't feel like a big deal. But one, let me just say it's actually a felony to sell those. You really don't want to mess with this on any level. But the reality is, is it's happening and College Is Fine Podcast: Right. Jill Grimes: The misinformation out there is that by taking one of these prescription stimulants, that it's going to improve your grades. ⁓ Might it improve your focus in the moment? It might, but probably not if you don't have ADHD. It's like taking, one of the best descriptions I ever heard was a tire, like a tire on a bicycle. And if it is half inflated, you can still ride on it. College Is Fine Podcast: I know. Jill Grimes: but you can write on it much better when it's fully inflated. But if it's fully inflated and you add more air to it, you're just at risk of it popping. You're not really at risk of, it's not really gonna help, right? So the same way, if you've got an ADHD brain. College Is Fine Podcast: Mm-hmm. Sarah: Mmm. Yeah. Jill Grimes: taking those stimulant medications will help you. It's adding that air that you need just to get to normal. And I don't know if you guys saw the recent studies that came out. I haven't had a chance to fully read it. It was out of Wash U, really good study. instead of, we've always said that these ADHD meds increase your attention, but it's really that they increase more your alertness. And then, ⁓ you know, if you're more alert, College Is Fine Podcast: Mm-hmm. Yes, yeah. ⁓ Sarah: Mm-hmm. Jill Grimes: and it sort of primes your pleasure center of your brain. So when it releases that dopamine and norepinephrine, which we know those are pleasure hits, right? We always talk about on our phones, the dopamine hits, right? But the meds kind of prime your brain for that so that when you start studying this mundane task, you get happier hits from it as you start studying. And so it feeds into that. So I think that's really interesting that. College Is Fine Podcast: Mm-hmm. Jill Grimes: that it looks like that's more the mechanism of these medications. But again, if you don't have a deficit, it's not really gonna help very much and the risks are high. And they're certainly gonna impair your quality of sleep, ⁓ as does nicotine, as does high dose caffeine. ⁓ And so they're really not helpful. They don't improve your grades. College Is Fine Podcast: Right. Mm-hmm. Yeah, yeah. Sarah: Well, I actually, can I just ask a quick question? Because again, you get to correct me if I'm wrong, but my understanding or anytime I've recommended this or spoken or collaborated with a psychiatrist is, before you get prescribed these medications, they do a lot of tests and things like your heart and they don't prescribe them until they say you're physically ready. And I think people forget that people who are getting these prescriptions, ⁓ the right way have been vetted to have a body or a heart that can handle those things. Jill Grimes: Sure. Yes. Sarah: And also we see a lot with anxiety that there are certain times where you start to take certain medications and it can lead to other side effects like kind of bring out some ticks or amp up some OCD that was a little bit latent. it's again, these are not things to, when people are deciding to take these medications because they might need them, they are going through the risk benefit, right? Or we're looking at a family history and saying, okay, there's a strong family history of X, Y, and Y. Jill Grimes: Right. Right. Right. Sarah: I don't know. I don't know that that's always thought about when people are grabbing them from a friend. College Is Fine Podcast: Mm-hmm. Jill Grimes: Right, and the reality is that in a young person, we don't routinely necessarily do even EKGs. It's not really the heart that we're worried about, but definitely the psychiatric comorbidities, right? There's obviously tons of anxiety and depression, and they're not drugs to toy with. And they do interact with other prescription medicines, and they interact with over-the-counter supplements. Sarah: Mm-hmm. Mm-hmm. Jill Grimes: there's something called serotonin syndrome that when people start, which I wanted to mention, when people start taking all these over-the-counter supplements, especially if they're on other medications, we need to start worrying about those kind of chemical interactions. College Is Fine Podcast: Mm-hmm. Sarah: Mm-hmm. College Is Fine Podcast: Hmm. mean, yeah, I mean, there's so many so many key points I want to like summarize before we move on. think one and a head of psychiatry at a local hospital in New York City had said to me once ⁓ the best way to know somebody doesn't have ADHD is when they actually take a stimulant, because like it does not do the impact that it's supposed to. Right. If anything, actually is like ⁓ going to. decrease your focus, almost like a party, like a of a party drug as opposed to a drug that's helping you kind of narrow your focus, right? And the other thing when you were talking about it is that a lot of kids I know are doing all three of these things, nicotine, energy drinks, and over the counter, prescription medications, which to me, I'm like, when you talk about it in terms of what that actually is doing to your physiology, it's really scary. Sarah: Mm-hmm. Jill Grimes: Right. Sarah: Mm-hmm. Jill Grimes: Right. Yes. Yep. Agreed. And there's so much lack of perceived risk because this has been so normalized. And the problem is move to the weekend and you add in over intoxication with alcohol, with weed. There's so many different substances that are coming into play and then we end up seeing seizures and we end up seeing other toxicities. So it's the really They're not something to idly choose. And again, legally, does it get caught very often? I'm not here to fear monger, but when it is caught, it ruins your life because a felony you don't get rid of. College Is Fine Podcast: Right. Sarah: Mm-hmm, mm-hmm, mm-hmm, felony. Ooh, that's a big word. Well, okay, I know that we have, I feel really convinced, I mean, you kind of had me at hello a little bit, right? But that ⁓ doing a lot of these things might feel, it might be sort of, it might seem normalized in a way, but we're saying, okay, just because a lot of people are doing it doesn't mean it's not hurting your body or putting you at risk for something. Jill Grimes: Yeah. College Is Fine Podcast: Mm-hmm. Jill Grimes: It's not risky, right? Sarah: But then you also have this thing of like, okay, but I just got to get through this one test. And then we were talking about that cycle where there's the test anxiety to kind of wake you up. And then there's the need to then put yourself to sleep, which includes other sleep medications. Can we talk a little bit about the sleep cycle part, what people tend to do to get that sleep quickly? Sleep gummies are out there all over the place, CBD. And then you also have things like Unisom over the counter. Jill Grimes: Mm-hmm. Sarah: sleep aids. So what about that side of the cycle? Jill Grimes: Right, so all the over-the-counter products that are like Unisom, Advil PM, Tylenol PM, anything with a PM on it pretty much has Benadryl in it, straight up Benadryl. ⁓ Benadryl is an antihistamine, we know that. Will it help you fall asleep? Yeah, ⁓ but you will also likely feel mentally hungover in the morning and it's not a great idea if you have the tests the next day. College Is Fine Podcast: hungover. Yeah. Jill Grimes: That being said, do people use it sometimes? Yes. If you use it chronically, if you've just been having a problem and if you're caffeinating and nicotinine or whatever stimulant all day and then taking the antihistamine every night, it's actually not, it's gonna quit working anyway. But they screw up your quality of sleep. If you talk to sleep doctors who do nothing. but sleep, these are neurologists with way more education on this than even I have, but not even, but then I have, I have a moderate amount, ⁓ but they will tell you, really none of these things. And melatonin, okay, first of all, would call students to hear more is not better. This is the American way. If one milligram is good, three must be better, and six for sure is gonna work, right? No, no, no, no. Don't take that sound bite out. College Is Fine Podcast: Yeah. I know, such a mess. I know. Jill Grimes: Out of context, get the no, no, no in there. ⁓ So, more is not better. Melatonin is to be taken a couple hours before bedtime, not at bedtime. If you're going to do it, ⁓ ideally talk to your doctor about it, but it's not something you take as you're going to bed. The antihistamines, again, they're gonna mess up your quality of sleep, decrease your deep sleep and your REM sleep. the rapid eye movement sleep that's more restorative. which is, but people are like, well, what do I do in the moment? I can't sleep right now. Okay, so here are my suggestions. I'm sure that you guys are a big fan of CBT-I, right? CBT with cognitive behavioral therapy for insomnia. Huge fan, definitely recommend that. There's an app for that and lots to be said there. Sarah: Mm-hmm. Right, right. College Is Fine Podcast: Yeah. Yeah. Yeah. Mm-hmm. Sarah: Mm-hmm. ⁓ College Is Fine Podcast: Mm-hmm. Sarah: Right, right. Jill Grimes: Obviously you can't do all of that in the moment at night. So some of the things that I recommend are number one, really popular with college students is sleep stories. ⁓ you know, it's amazing how that just kind of calm voice and it distracts your brain. Another technique that I really like is called cognitive shuffling. And I don't know if you guys talk about that, but the one I like is where you think of a word like cat. Sarah: Mm-hmm. Mm-hmm. Yep. College Is Fine Podcast: Yeah, love them. On com, yeah. Mm-hmm. Jill Grimes: And then the next word has to start with a T and then so tiger. And the next word has to start with an R. So you start the next word with the ending letter of the previous one. And it really focuses your brain on that and takes your brain off of that repetitive cycle of, my God, I'm in a flunk. So I think learning some of those strategies, any kind of guided meditation. College Is Fine Podcast: Mm-hmm. Right, right. Sarah: Yeah. Jill Grimes: Having comfortable, not uncomfortable headphones like this or earbuds, but having the sweatband style. think, I mean, you that's a $15 thing on Amazon that I think is money well spent so that you can fall asleep to that guided meditation and not have uncomfortable earbuds stuck in your ear. That's really gonna, that's not good for your, right, right. Sarah: Mm-hmm. College Is Fine Podcast: Mm-hmm. Sarah: Mm-hmm. Yeah, that they kind of wake you up to kind of take off. I think that one of the things we also see is that the more people try to chase sleep and catch it, the more anxious they get about getting it. So I'll add to that, like oftentimes with kids, again, like a quick hit is like, assume you're going to have times that are difficult to fall asleep. We all do have a little section or something near you to do something boring, but College Is Fine Podcast: Right. Jill Grimes: Yes. Right. Sarah: just engaging enough to distract you, not gonna, read a thriller, Crossword puzzles, something of that nature, just to give you something that feels mundane, a little boring, but somewhat distracting, like those sleep stories. And then the other part is be okay with being tired the next day. You know, don't catastrophize that that lack of sleep is gonna be the worst thing ever. You'll survive. You know, it's sort of like, okay, I'll try this. And if I don't get any sleep, I'll be tired, but I've been tired before. Jill Grimes: Right. Yes. College Is Fine Podcast: Right. Sarah: you know, cause those anxious thoughts can get you even more revved up and that you kind of try to fight harder. Um, and again, pile on all these other ways to try to sleep and it's sort of like, let go of the rope. Worst case scenario is you're tired. You'll be okay. Um, yeah. So, Hmm. Jill Grimes: Mm-hmm. Yep. That's really good advice. And exercise. I want to throw in a big plug, college students, for morning exercise, or at least early afternoon, not late at night exercise. But I always want to be sure that they understand that, I mean, how many studies have we had over the past 50 years that show us that daily aerobic activity, sustained daily aerobic activity, decreases anxiety and depression? And it's not like, 30 minutes a day of walking is gonna cure everybody from their depression and anxiety, but it's gonna help. Sarah: Yeah, people forget it might be keeping them their head above water more than they think. College Is Fine Podcast: Mm-hmm. Jill Grimes: Right, right, especially freshmen who were athletes in high school who are not in teams when they get to college because you take for granted how many hours of dance or marching band or whatever it was that you were constantly moving. So I think that's a really important element to bring back in. College Is Fine Podcast: Yeah. Sarah: Mm-hmm. College Is Fine Podcast: Yeah. Yeah. Sarah: Yeah. ⁓ gosh. College Is Fine Podcast: Yeah, I mean, I tell all my patients, they'll sometimes be like, why am I always promoting exercise? And I always say like, for me, it really is sleep. I'm somebody that like in undergrad and graduate school, like I'm vulnerable to insomnia. I'm definitely somebody who's vulnerable to like, worrie, intrusive worry. And if I don't exercise consistently, my mind and just like my natural body chemistry is too... Jill Grimes: Mm-hmm. College Is Fine Podcast: aroused at nighttime that I like really have difficulty kind of falling asleep. So, okay. So you mentioned, I want to kind of summarize and go back to the anxiety. You mentioned some things around like maybe why to resist these urges for these quick fixes, both in terms of like the risks, the interactions with other things that are going on and also because it's probably not giving you the desired effects that you want. Right. ⁓ And then some tools about how to ⁓ Jill Grimes: Right, right. College Is Fine Podcast: get more well rested and fall asleep without these aids. What about the anxiety side? I'm assuming exercise is part of it. But what would you suggest for these, OK, maybe I resist the urge to take a steady drug, or I'm trying to reduce caffeine or nicotine, but I'm still really overwhelmed and anxious and really having a hard time focusing. You mentioned one thing. You did say sleep. probably would be like an area to pay attention to that might help with your alertness and focus. But maybe speak more on that or any other thoughts about how students can handle that area. Jill Grimes: Sure, so the first is literally to do everything to optimize your sleep. And we talk about this a lot right at the beginning of each semester because you always have new students showing up. But recognize that it is harder to sleep in a room with somebody else when you've had your own bedroom growing up, which most college students have had that luxury. So you have to do all the things. so keeping it cool, College Is Fine Podcast: Yeah. Yes, yes. Right. Jill Grimes: having a fan, getting the blackout, blinds, not blinds, blackout ⁓ eye masks, sleep masks for you. So I like the combined sleep mask with the earphones. ⁓ Because you can't necessarily control the light coming in or your roommate coming in and flipping on lights. Excuse me one sec. Allergies. College Is Fine Podcast: Yeah Sarah: Mm-hmm. College Is Fine Podcast: Yeah. Sarah: Mm-hmm. Mm-hmm. Jill Grimes: So optimizing that, everything including odors, if your room smells terrible, that can keep you, do all the things for all the senses. right. College Is Fine Podcast: Yeah. Yeah. Sarah: Yeah, just don't expect it's going to come naturally necessarily. Like be okay with saying, I have to have some helpers here. Right, because I think you just assume like, ⁓ it's going to be fine. But yeah, roommates coming in middle of the night, you want to nap, you can't always like, you're right, your sleep schedule in some way can get bogarted or stolen from you. Jill Grimes: Yes. College Is Fine Podcast: Yeah. Jill Grimes: No. Are you... Right. College Is Fine Podcast: Right, right. Jill Grimes: Right. The other thing is that it's more important to have a consistent wake up time. Let's talk about the circadian rhythm part. You know, if you're going to bed at 3 a.m. every night, honestly, I don't care as long as you're getting up consistently at the same time, because that's more important for your circadian rhythm. And if you're going to bed at 3 a.m., I'm hoping you're sleeping till 11 a.m. It depends on your class schedule, but you can't. College Is Fine Podcast: Yeah. Yeah. Mm-hmm. Jill Grimes: get up at noon one day and get up at 7 a.m. the next day and sleep and think that you're gonna get this makeup sleep on the weekends. It really doesn't work that way. So prioritizing your sleep schedule, nutrition, you know, this is boring stuff, but you gotta get sleep, you gotta eat better. But it's true, your body wants good fuel to make you feel good. We hear all the time, ⁓ I'm tired all the time, I'm just exhausted. College Is Fine Podcast: Yeah. I know. Jill Grimes: and some of that's mental exhaustion and some of it's really not putting decent fuel in your body. So we gotta go back to when's the last time you had a vegetable? I love doing 24 hour dietary recalls with college students because, and adults and everybody, honestly, not to pick on them to say, oh, you're not eating well. I mean, this is not that kind of thing. It's to point out, wow, I thought I ate decently yesterday but I didn't have a single fruit or vegetable. Sarah: Mm-hmm. College Is Fine Podcast: Yeah. ⁓ Sarah: Yeah College Is Fine Podcast: Right, right. Sarah: Yeah. Jill Grimes: changing that up, getting a smoothie instead of a coffee drink in the afternoon. I think all of that is important. And I wanted to go back to say on the sleep gummies, I was thinking of the legal sleep gummies, but I wanna make mention of ones that are not legal if you were under 21 and in a bunch of states, it's still illegal, and that's the THC gummies. And I really wanna emphasize, College Is Fine Podcast: Yeah, yeah, yeah. Sarah: Mm-hmm. Jill Grimes: that those can be very habit forming. They are addictive. It is a higher dose. It is an addictive substance. One in 16s will get addicted. And the problem is, do you know what withdrawal symptoms are? They're all the symptoms that you started taking them for, right? Anxiety and insomnia, especially anxiety and insomnia. So what we see, and I'm sure what you see is a lot of. College Is Fine Podcast: Mm-hmm. I know, right? It's a far, yeah. Yeah. Sarah: Mm-hmm. Jill Grimes: students who start using those because a friend says, ⁓ my gosh, just take this gummy and get some sleep. Just take this or just take this Xanax, which is a prescription sedative. And we also need to worry about fentanyl being in the Xanax because if you're getting it from a friend, it's less likely that they're getting it from their doctor. So I just wanna, you Sarah: Mm-hmm. College Is Fine Podcast: Hmm. Sarah: Right. College Is Fine Podcast: Right. Sarah: Mm-hmm, mm-hmm. Jill Grimes: Increase awareness of those and and and no judgment. mean listen, we've all been there. ⁓ my God. I'm exhausted. I haven't slept in three days, right? And I just I just want to sleep and your friend or your suitemate or somebody says here is a quick fix. Who isn't going to want to take that? We're all going to want to take that. But it needs to be an informed choice. Sarah: would have been doing all the things. Yeah, every single one of these. College Is Fine Podcast: Yeah, yeah. Right, right, right. Sarah: Right, I like that idea of just being like, at least be aware, right? At least be aware of what's actually happening, know the alternatives, ⁓ and here and there, it's gonna, I'm sure people can listen to this and buy into it and still might be like, all right, but at least just know and think through the quick fix or how it helps right now versus down the road. What do you want to do? Do you wanna keep on relying on the quick fix or are there some? bits you can start to build now that will ultimately be wonderful in college and outside of college. A lot of times too, I find that with people who are doing edibles or smoking weed to manage anxiety and things like that, there is also that lack of motivation that comes with it. kind of has a tail, right? And so if you're anxious about a test and then you smoke weed to deal with that, then the chances that you might feel some meh, you know, College Is Fine Podcast: Yeah. Sarah: And you don't engage in the studying that you need to also can impact you. every, any sort of quick fix tends to have a longer term outcome to think about. So at least think about it, at least know what you're getting into before. So awareness is a big, a big deal. And I really thank you so much for bringing in that actual doctor perspective of what's going, of what's going on. So you've officially prescribed these things. Thank you. College Is Fine Podcast: Mm-hmm. Right. Jill Grimes: Right. Right. Yes, and I want to say that alcohol, everyone's like, okay, well, I'll just have, I'll just, you know, I see my mom have a glass of wine before bed and maybe I'll have, you know, whatever, right? Or do a shot or whatever. But the thing is, yes, alcohol is a sedative. It will make you sleepy, but it impairs your quality of sleep. But I want to acknowledge that there's a reason people do, whether it's a nicotine to... Sarah: Mm-hmm. Mm-hmm. College Is Fine Podcast: Yeah, yeah. Sarah: Right. Jill Grimes: to hype them up or caffeine or alcohol or weed, they do have immediate effects that are quote beneficial. It's what you're looking for, but you need to understand that the ultimate outcome is not good. And I really want people to understand on the THC gummies that if you've been using them for a long time and your insomnia and anxiety are getting worse, they are contributing to the problem. College Is Fine Podcast: Right. Sarah: Mm-hmm. Mm-hmm. Ugh. I wish we had you on speed dial. College Is Fine Podcast: Right. Patrick Grimes, this was amazing. mean, I know. I really, think, you know, if I had to summarize, I would, really feel, hope people feel hopeful that there are ways to get your body working better for you and to get your brain working better that are not some of these quick fixes. They might take a lot of effort. There are things that most of America kind of, think, struggles with, not just college students in terms of regulating our sleep, moving our body, being mindful of our nutrition. Jill Grimes: Sure. College Is Fine Podcast: But I hope people can leave kind of feeling like, okay, there might be some things that I could do even on a college campus that can help me feel less anxious and more well rested and therefore, you know, being more successful academically. Jill Grimes: Yes, I would say, know, practical steps to take today, cut your caffeine intake by a third. You don't stop it completely or you're have a withdrawal headache if you've been using a lot of caffeine, but cut that down. I don't like nicotine in any form. I would like you to not do that at all. ⁓ And start the exercise and try some of these. Sarah: All right. College Is Fine Podcast: Right. Yeah. Sarah: Mm-hmm. Jill Grimes: sleep techniques in the middle of the night, like the cognitive shuffle where you do the word finding or the sleep stories. College Is Fine Podcast: Yeah, love. Yeah. Sarah: Yeah. And we'll put a lot of these resources in the show notes if people are interested. We definitely have some episodes that have talked more in detail about that. So we'll link it up there. I appreciate just your open, honest, very clear take on all of this. ⁓ And I also think just for the other listeners out there, you probably don't have a goiter. OK? Just not my medical opinion, but it's Jill Grimes: And even if you do, it's not a thick neck. Sarah: It's probably, you probably just have an extra thick neck. ⁓ yeah. I think I just have a pinhead. think I have an, an off head to neck ratio. All right, back to business. This has been great. Dr. Grimes. College Is Fine Podcast: So. ⁓ just look at Sarah's neck and these videos guys. ⁓ Jill Grimes: They're tiny. It's tiny and slender like a giraffe. College Is Fine Podcast: All right ⁓ Okay, and please, we'll, yes, it's been great. We'll include your book as well, which also, and also ⁓ your social media, which I really feel like has such great quick little videos on topics that so commonly come up in college. ⁓ So thanks so much for coming on. We appreciate it. Sarah: Yeah. Jill Grimes: Thanks for having me, I appreciate it.