Pharmacists' Mental Health | Lisa Nezneski, PharmD, The Meditating Pharmacist

Speech to text:

Mike Koelzer, Host: [00:00:00] Lisa for those that haven't come across you online, introduce yourself and tell our listeners what we're talking about 

Lisa Nezneski, PharmD: today. My name is Lisa Nezneski. I am a meditating pharmacist. I've been a pharmacist for 40 

Mike Koelzer, Host: years. Someone's listening to this and they say, oh, Mike, you've gone off the deep end. Now you're talking to all these crazy meditators for all the people that are about ready to flip off the program.

Am I just talking to a crazy person? 

Lisa Nezneski, PharmD: Well, I'm sure there's more than one person in my family would say that I am crazy but, 

Mike Koelzer, Host: um, but you're a crazy nut, Lisa that talks about meditation, all this new age 

Lisa Nezneski, PharmD: stuff, right? Yeah. I've actually got a foot firmly in each camp. You know, I believe in the benefits of traditional medicine and medications, and I also believe in the wisdom of natural, traditional and other healing modalities.

Mike Koelzer, Host: All right. So pharmacists thought black and white were on and off were something right. Or it's wrong. Someone could say that's the last person that needs meditation. I'm thinking that you're gonna say the opposite of. 

Lisa Nezneski, PharmD: Is there a personality type that's drawn towards pharmacy. Absolutely. You know, the, so, um, we all tend to be type A's.

We tend to be on top of things. We tend to double check things. We tend to have checklists. We tend to live in our heads. But where life happens is in our hearts. And so meditation helps you drop into your heart, be in the present moment, have your body, mind and spirit in the same location at the same time and not ignore it.

Mike Koelzer, Host: I think there's a lot of pharmacists, especially maybe our listeners who are owners. A lot of that black and white stuff happens during the day when they're checking a prescription or helping somebody with a dosing decision or something like that. And I think sometimes their body comes home maybe for a late dinner and their husband or wife might be talking to them or their kids might be talking to them.

Their brain is somewhere still between their business and their home. And sometimes their brain doesn't catch up to them till about 1130 at night, just in time for bed to wake up and start things over again. 

Lisa Nezneski, PharmD: Yeah. Or ruminate on things all night long. that are you keep you 

Mike Koelzer, Host: up asleep? 1130 if you're lucky, 

Lisa Nezneski, PharmD: right?

Yeah, exactly. Um, I've been there. You know, I, I own, I own my own consulting business for many years. And if, if mom didn't work, we didn't eat so many of those concerns were real payroll, making sure that, you know, I was getting paid from my suppliers as well. You know, who, whomever that owed me money.

Um, so it was, um, you know, I've, I've lived that particular life and. It's somewhat of a younger person's life. If that makes sense to you as you age, you can't keep that pace up. It's not sustainable. And some things do have to change. And, and in, in my life I made a complete pivot when things were, you know, I pushed as long and as hard as I could for things to be sustainable.

And then, um, through no fault of my own, I owed. The IRS $35,000 had to sell my house, had to move. I, I, you know, I downsized completely and went through some real soul searching moments and, you know, I don't want anyone else to have to do that, but. But there is, there is light on the other side of that. You know, you don't have to get into a catastrophic situation, I guess is what I'm saying.

So, uh, you know, really mindfulness is just paying attention to what is happening, really paying attention. You are listening to me. So, uh, intensely right now I can see your, you know, your, your eyes are making contact with my eyes and really that's all it takes when you're, when you get home, you have to hang up that pharmacist lab coat.

Start to pay attention, because these are the things that really matter to you. These people in your life whatever's happening at that moment. You wanna be there for it. You wanna be there for your family, for your, uh, you know, work will wait tomorrow. You can't solve those problems overnight. You know, they didn't happen in one instance.

So, you know, maybe giving yourself some grace and some space. A better answer will come in. And that's what I found. Uh, the utility for me of meditation is a better [00:05:00] answer comes in the quiet moments. 

Mike Koelzer, Host: You're telling me that a problem is not best solved by thinking about it 24 7. 

Lisa Nezneski, PharmD: Well, that's exactly what I'm saying.

You know, this, first of all, the thought that came to mind was that. The thinking pattern that got you into that problem is not going to be the thinking pattern that gets you out of it. You've already perfected getting yourself into that jam, even if you're just giving yourself a break. You know, even if it's watching a football game, even if it's something where you are not thinking about your issue, let's 

Mike Koelzer, Host: just pick a simple issue.

Some question that someone brought up or you've gotta figure out something that maybe is deeper than just a yes, no question. Maybe it deals with some of your psyche and who you are as a person, it gets to your identity and so on. Even if you're. 10 minutes into this trance of thinking. If you could have figured it out, you would've already realized that you're there means that you probably don't have everything you need and maybe taking a little break, whatever it is, shifts your mindset a little bit.

Lisa Nezneski, PharmD: Right. Exactly. Like if you remember back to when you were learning pharmacology the first couple times through you, it didn't register. But when you took a break and walked away and came back to it, all of a sudden your brain was able to integrate that. And we've learned these problem solving skills just by going through pharmacy school.

Allowing the brain, uh, some time to rest and focus on something different. I like to, uh, listen to music when I'm trying to solve a problem. So I'm integrating left and right to halves of the brain, you know, doing something different out of the norm. Uh, you can get a pretty good insight. 

Mike Koelzer, Host: It's the old term that I tend to use.

And maybe these young punks don't use this term anymore, but we used to call it, putting something on the back burner. It's letting it simmer back there. And sometimes some different answers can come to you. 

Lisa Nezneski, PharmD: It's allowing your subconscious to work it out. Our cognitive skills got us to where we are today, you know, but we're so much more than that.

And allowing ourselves to sit with how a particular answer makes us feel inside sometimes gives. Better insight, you know? So if you're thinking of a particularly prickly problem, well, let's say we've got two alternatives that are just about equal, you know? Yeah. If you can think about an alternative one and you're like, Ooh, that makes my stomach hurt.

and then problem two it's like, oh, okay. Let me try that one. I, I don't feel so bad getting a read on, on how it impacts your body, because I had a near riot in the pharmacy when I made them all take a lunch break. You know, when I was a director of pharmacy, I liked institutes. You have to take your lunch break and you know, we're just so used to driving, driving, driving, driving, go, go, go, go, go, go.

You know, taking that pause will allow for something better to come in and you can sense your. You know, we're, we're in this amazing biological mechanism here. That's so much more than that. You know, we've got emotions, we've got our mind, we've got spirit, we've got our physicality. There's, you know, basically four different layers to all of that.

And as we, you know, go through life, stuck in our heads, we're missing things, 

Mike Koelzer, Host: had a customer. This is a few weeks ago, he was talking about decision making and he says, when I'm making a decision. I pretend like I'm flipping a coin two outta three times. And you know, my mind, if two flips out of the three, go my way.

If I'm wishing that I was three out of five, then I realize I've got my answer. I should have gone the other way, you know, mentally. Sure. When something bothers you, if you take the time to think about it, you can actually feel in your body where it's hurting you. That's exactly right. A tight neck. Your shoulders are tight or it's something in your gut or your, your upper back hurts or something like that.

And if you can then make room for that feeling and actually think, where does this hurt on my body? Not trying to solve the problem. Just listen to your body. there's some good stuff there. You're on the right track. 

Lisa Nezneski, PharmD: Well, you know, one of the basic, uh, anchors of mindfulness, when you learn to meditate is paying attention to the sensations in your body that you just described.

The other two are breath and ambient sounds, but paying attention to those feelings, you know, of, of [00:10:00] pain, and you can even investigate it a little bit further by asking about that pain. What does it need? And what is it trying to tell you? So, yeah, you're absolutely on the right track yourself. When you're talking about paying attention to how things make you feel in your body.

That's, that's one of the basic anchors of mindfulness and you can sit, you know, for a five to 10 minute period and just kind of feel into that sensation. To tolerance, you know, we're not asking you if it's super painful to just sit there and be in pain, but investigate it, you know, from, from a very nurturing point of view, like, what is it that you need?

What can I do, what can I do to help you? 

Mike Koelzer, Host: What I've learned recently is once you've identified that pain, the really hard part, which I think is valuable is naming like in one word, What's really going on. Is it fear? Is it jealousy? Whatever 's really going on. That's hard to do 

Lisa Nezneski, PharmD: the naming part of it. It sometimes helps take the charge off of it.

What you're talking about really is an emotion

Mike Koelzer, Host: from my understanding, the problem. If we don't take the time to. Let that emotion happen. Feel it, maybe name it, maybe nurture it a little bit. If we don't do that, we're taking the energy that maybe would solve things and maybe give us some comfort by listening to ourselves better. We're blocking that way up front and quite often then we're blocking it.

Coming home and watching TV or picking out butter, pecan ice cream, or kicking the dog or doing whatever the problem is. We haven't given our body any answers. We're spending all the energy at the very top fighting it. And if you don't listen to it, it's gonna keep coming back and poking at you and saying, listen to me, I need to be listened to.

Lisa Nezneski, PharmD: That's exactly right. So my story is that I ended up in the emergency room with a heart rate that was dropping and dropping and dropping. I had chest pain, so there's really nothing wrong with my heart, but you know, there were some seriously unresolved emotions there that, um, my heart rate got down to 28, really.

Yes before I took a deep breath and the pain subsided, and then it started to climb back up. So, yeah, it's a scary, I thought I was checking out what 

Mike Koelzer, Host: emotion is that that would lower it. 

Lisa Nezneski, PharmD: Well, that's a good question. And, and I'm still on that quest to find the exact answer, but I was pretty angry at the time I had, oh, I was, I was overworked.

I had, uh, 275 employees at the hospital. Wow. Yeah. I had five departments besides pharmacy. I had a lab. Makes sense, right? Lab medical oncology, radiation oncology, and research. So I had those five departments and as I said, a lot of employees and a lot of, you know, responsibilities. Plus I was driving 120 miles a day.

60 each way back and forth. I did that for four years. So I burned myself out. I, um, was not taking care of myself during that time period. Um, I was undergoing some serious financial stress. The IRS came back and basically gave me another mortgage payment that I had to pay every single month. Something was not working.

Clearly. I basically changed everything. So I changed where I was living. change where I was working changed, uh, significant others. I had to figure life out pretty quickly. I had to examine what I call my personal core foundation. So if it wasn't, you know, part of that personal core foundation, It left my life, you know, and that was like spiritual health, healthy body, financial health, good work life, good home life and so on.

So all of those areas, if it wasn't building and nourishing and creating a positive environment, it had to go, 

Mike Koelzer, Host: someone busy is hearing this and here's be mindful. They're like bull crap. It's not gonna work. Don't tell me to relax when I've got problems to solve. Are there steps that somebody can do in that situation instead of just telling them to relax?

Lisa Nezneski, PharmD: Right, right. I mean, certainly if you just tell somebody to relax, they're gonna get [00:15:00] ticked off. You know, they're gonna feel like you have no understanding of what it is that I'm going through at the moment. No one understands that. One of the very simplest things that you can do is to take a deep breath, actually three deep breaths in a row, making your exhalation slightly longer than your inhalation.

Your eyes are open. You're not sitting on a cushion. You're not up on a mountain. You're not sitting with a guru. You're just taking three. Deep breaths and the exhalation being longer. And what that does is it triggers your parasympathetic nervous system. We live so much in the sympathetic nervous system.

Get things done, adrenaline, adrenaline, let's go, let's get this done. This has gotta be done. But if you just take three simple breaths, It reverses that and puts you back into the parasympathetic nervous system and, uh, some call it the rest and digest system. Hmm. That's why it happens at night while you're sleeping.

But, uh, you know, what, if you can do that consciously, you can bring yourself back to, okay. I know what to do next. You'll actually be more aware of what's going on around you, which is exactly what mindfulness is. Mindfulness is awareness of what is happening in the present moment. 

Mike Koelzer, Host: Really the difference between an animal and a human is that one ability right there to separate that thought.

From the action. Exactly. That's what dogs and lions go down the list. They don't have that time between input and response. And so that three breath instruction, people might look at that and say, that's hogwash. It's like, no, it's not that's humanity. That's what makes us human, having time between that impact and the 

Lisa Nezneski, PharmD: response.

Exactly. It's attributed to Victor Frankel. Uh, but I haven't been able to trace it to him specifically. Steven Covey quoted him as saying between stimulus and response, their lies, the space and the space is where the magic lies. 

Mike Koelzer, Host: Yeah. Frankel was, uh, he was. 

Lisa Nezneski, PharmD: A Holocaust survivor psychiatrist, Holocaust survivor.

Yeah. Yeah. 

Mike Koelzer, Host: Psychiatrist. He was a psychiatrist before he went in. 

Lisa Nezneski, PharmD: Yes, I imagine so. I don't don't know his history, but yes, he was a physician. Interesting. He administer to, to people in, in, um, I believe he was in Auschwitz 

Mike Koelzer, Host: and he put kind of a meaning to that. 

Lisa Nezneski, PharmD: Right. Man, search for meaning is his 

Mike Koelzer, Host: book. I had years when people would tell me to be mindful and I.

Oh crap. I'm not doing, you know, I, I couldn't get it up here. And finally, it's gradually kicking in when you're responding to things. You think you're doing it out of wisdom, but you're actually doing it from your kind of lizard brain. You think you're getting a good response, in actuality, if you give yourself a chance to rest a little bit, bring that emotion down.

Part of the reason that you are able to have a new thought is. You're using a whole different part of your brain. That's exactly 

Lisa Nezneski, PharmD: right. You're triggering the subconscious to work on the problem, the issue, the concern. You know, some may say, we just turn it over to God, you know, let, let God solve the problem.

There are seven questions in the seven mindful questions and question number four is pause and breathe. And we've been talking a lot about that. And, um, you know, there are sometimes that there is no good answer per se. There are shades of gray. So if you allow yourself to sit with that gray for a while, grace enters in.

Hmm. So out of gray comes grace. And when, when you have that, uh, feeling of grace, then you can make the wiser choice that you know, is, is in the best interest of all interested parties. So it's sort of a negotiation technique, but it's, you know, the seven questions, but, you know, I started off with, what am I doing?

Right. Why am I doing this? Which is the second question, which is the because, so it's awareness and because, and then why do I care? Is it part of my personal core foundation? Does it enhance my spiritual life or my health or my family? I don't know. As a pharmacist, sometimes you're offered a job. That, uh, will require you to work, uh, do while your children are having games and things, you know, sports games, and you're having to, to make a decision whether or not that's worth it to you.

Mm-hmm and of course you can, you will be able to [00:20:00] make. That decision for yourself. But my point is considering how that impacts your overall personal core foundation, what you're willing to, uh, to live with. And then the pause and breathe is number four. And that's where you, uh, Figure out what it is that the process that you wanna go next, you know, what is essential is, is part of that question, pause and breathe.

What is essential, and then moving forward, you start to make choices and the acronym goes, choose a better alternative. So choose what choices that question five is the emotional heart. The seven mindful questions where you're starting to make choices, paying attention to how your body feels. And, and, you know, I'd, I'd worked with this method for a very long time before I even realized that that's the most, uh, useful.

That question five is when you start to pay attention, you know, when what's essential, you know, you can think about, you know, certain things in your head, but when you start to re relate it back down to your heart and then better, you know, is, uh, what's the better choice to make. And we've all made crazy mistakes where we shouldn't have and know better, but we still move forward and get ourselves into tangles with things that, you know, it's part, again, part of the human condition.

We all do that. And if you can learn from it and move forward, and then finally the last is what is the best alternative. So you're, you're going through all of this and basically what does it mean? What is the most important thing for me to be doing right now that sums up question number seven, you know, what, what, what is the best alternative you can use when you're negotiating or working with, you know, across the table in a negotiation situation.

But, um, you know, what is the most important thing for me to be doing right now? When you mentioned, you know, that reset that you take in the middle of the day, that's really, um, helps you stay on track with what is important to you. For me, I'm 

Mike Koelzer, Host: Thinking more that if I'm in this emotional pissed off mood, because someone challenged my identity as a boss or something like that, I can't picture getting through those thoughts when I can't even catch my breath.

I'm so pissed off about something. 

Lisa Nezneski, PharmD: Well, exactly. And, when you have really strong emotions, you need to just let them run their course. , you know, you can't stop them in their tracks because if you're gonna do that, you're gonna stuff them down. And they're gonna come out when you have a heart rate of 28 

Mike Koelzer, Host: don't fight 'em 

Lisa Nezneski, PharmD: yes, you can almost say to yourself, this is justifiable anger.

If somebody's coming at me with this, I should be upset about this and it's okay to be upset. And let that upset run through you. And sometimes it's taking a long walk mm-hmm I can't tell you how many long walks I walked off, you know, the, the, um, cause middle management in the hospital, you've got the administrators above you and you've got your employees below you.

So you're really in this no win position where, you know, I just, sometimes I would go out and walk and walk and walk until. You know, it sort of felt a little better, like, okay. 

Mike Koelzer, Host: You know what I found? Isn't really good for you. What five bowls of honey? Bunches of oats at night when you're upset about something.

Cuz that was my life until about a year or two ago. 

Lisa Nezneski, PharmD: Oh wow. So you're an emotional eater. Yes. Is that what you're saying? Yes. Okay. 

Mike Koelzer, Host: It's been something I've been working on for like 15 years and I'm finally, it's kind of getting into my head 

Lisa Nezneski, PharmD: now. Congratulations. You're crunching off that anger with those honey bunches of votes.

Oh 

Mike Koelzer, Host: yeah. It's not like there's nothing there. I didn't do that with, you know, broccoli. I mean, there's something to the serotonin, the sugar, that kind of stuff. But you said eating your emotions. Is that what you're doing? You 

Lisa Nezneski, PharmD: can, yeah, there's an acronym. HaLT hungry, angry, lonely, tired. You find yourself eating for no reason.

You know, which of these are you, are you, are you really hungry or are you angry, lonely or tired? Yeah. That usually is unconscious eating. 

Mike Koelzer, Host: You get those emotions. Now what I'll try to do is I'll just try to name it. You know, I'll say like, all right, I'm feeling this way. Where is it in my body? Can I name it?

Oh, I'm. Anger. What are you angry about? I'm angry about this. Is it really angry? Well, I don't know. Maybe I'm afraid. What are you afraid of? Well, maybe I'm afraid that I'll be embarrassed in front of such and such. All right. So maybe it's embarrassing. Let the feeling come. Yeah. And what's the worst that could happen.

Even [00:25:00] that Lisa, if you don't take those three breaths, you can't even get to that stage. And before you know it I'm on my fourth or fifth bowl of honey bunches of oat. 

Lisa Nezneski, PharmD: E emotion needs to move through you. Emotion, it's energy and emotion E emotion for me, I have found that even now that I exercise every day, I feel something leaving my body when I am working out.

Like, I didn't even know. I felt that. And like, where was that? It was not conscious. And at this point I don't care what it was per se, as much as goodbye, you know, move out of my body. And it's an interesting sensation of tingling where I was holding tension and it's as it relaxes and moves out. So, um, I'm, I'm a big believer in using exercise, even if it's just walking to help that emotion move through.

Mike Koelzer, Host: Talking about my honey bunches of votes. So what I've been doing since about January is getting up and walking in the morning before work. So I'll walk three miles before work to do that though. I get tired around 10 o'clock. And so then I'm in bed at 10, instead of starting my. Cereal cascades at, you know, 10 30 to midnight.

I'm already in bed because I gotta get up. So that's about a, and I know we're not talking calories here. We're talking more emotions, but that's a calorie differential between going to bed, waking up and walking in the meantime, you're using up some of that energy when you're too damn tired to get anxious sometimes.

Lisa Nezneski, PharmD: You might have something there, you know, um, I'm a big believer in the hours before midnight, uh, in bed are, are really very therapeutic and, you know, there's hormonal cycles that your body goes through. The large muscles need to rest and, and repair your gut needs to rest and digest. So having, um, Uh, having a set sleep schedule, I think is important as well as having an exercise schedule.

So I think you've, you've got both ends of that working for you. Your 

Mike Koelzer, Host: The first book was on chaos that doesn't help. We all have the potential to be crazy. It's just how much chaos we're facing. And that's like, I've heard it put, we're all like a raft, you know, you buy from a store and this sea's gonna bust somewhere.

If you put enough chaos into it, that book 

Lisa Nezneski, PharmD: talks about my story, where I really was in such emotional pain and turmoil. That I had to keep my feet on the floor. I had to be grounded while all that was going on around me, you know, the eye of the hurricane. And, um, you know, the reason I wrote that book was so that others who have faced that kind of situation can look and say, okay, I can make it through and I can thrive.

Grounding was a technique that I learned. Several years before all of this situation happened to me where, you know, my life was basically, um, completely turned upside down. Grounding a technique where you appreciate that you are on the earth in this present moment. At this time you feel a connection to earth.

You know, we're, we're made of the stuff of earth, really feeling supported and held on the face of the earth that you are here. You're supposed to be here. You're in this place in time. Some people use the imagery of, uh, tree roots or waterfall or beam of light. Well, during that period of time, I had a steel braided cable that I was imagining going down to the center of the earth and using a carabiner to clip in because I felt like I was being whipped all over the place.

And so, um, just being in touch with the earth is very therapeutic. 

Mike Koelzer, Host: Sometimes when we get emotional, one of the first things we have to do is feel that we're safe. Absolutely. And that's kind of what I'm thinking about. Grounded sets a 

Lisa Nezneski, PharmD: container for you to, to be safe and supported. 

Mike Koelzer, Host: Exactly. When you were talking about exercising.

I was thinking about this because back in the early days of our evolution, and if you think about even now, you know, in the African planes, you know, zebras. Are supposed to get like an adrenaline rush, like maybe three minutes, about every three days when the lions are chasing them and then they [00:30:00] get that rush and then they've used it up and it's gone and they go back to being zebras.

But we as humans kind of have that lizard brain in our frontal cortex and they don't always play well together. So we start to feel. We're a zebra running like 24 7, and we're probably not the best thing for us. 

Lisa Nezneski, PharmD: Right. That's that sympathetic dominance that we sort of alluded to, the parasympathetic would be the, uh, relaxation system, but sympathetic would be, I'm not being chased by a lion.

I gotta keep running, you know, and, and the lion might be the, the pay into the bills, getting up in the morning, getting out the door, getting the kids out the door, all of those, doing things, you know, the human doing versus the human being, 

Mike Koelzer, Host: where to be anxiety Analytics and. The antidepressants play a part in this thinking.

And here's my question. Just as somebody who is maybe afraid of let's say going on elevators, the cognitive behavioral therapy would say let's. Expose the person to this. Let's get them to look at a picture of an elevator. And now let's have them go to a building where there's an elevator and watch people getting on and off.

And now let's have them look inside of an elevator. And so on until you finally go up and down the elevator, can it be argued that the anti anxiolytics and the antidepressants, which let's say numb the emotions a little. are not allowing you to get on those figurative elevators throughout the day. Not allowing you to get the wave of emotions and not allowing you to be exposed enough to the anxieties.

Lisa Nezneski, PharmD: Well, I think it's, it's a matter of degree, Mike. I, I, I do. I think it's a matter of degree. In other words, if this medication. Is a bridge for you to be a more functional person in society by all means take the pill. But if it's something that is completely. Blanking out your emotions, your ability to react in what you would feel a normal way you feel numb inside, or you feel, um, not yourself.

I mean, that's a common thing. We heart patients tell us that they, they, I don't just it's okay. But, you know, I don't feel the anxiety, but I just don't feel like myself. You know, we hear that a lot and. is that really what we want them to feel? You know? So thankfully these days we've got an entire armamentarium.

I mean, when I was in grad school, it was just Valium, you know, Valium and Librium and little AMRIP and you know, so, but now we've got an entire armamentarium. My own personal point of view is the, there is the right drug out there and. Very difficult in the timeframe till you find that right drug to continue functioning in society.

So 

Mike Koelzer, Host: about 15 years ago, I went through some pretty stressful times and got an SSRIs and they were good with one exception. They made my appetite go up. I know a lot of people that get on SSRIs and they just get fat and it's like, That's not a great option. So now I'm at the point where I went off. 'em, it's more stressful for me to be a fat ass than to feel some anxiety once in a 

Lisa Nezneski, PharmD: while.

Well, that gets down to what are you willing to live with? Well, that's right. Mm-hmm can you find more productive ways to deal with your anxiety, whether it be journaling or meditating versus going on the S Sri and gaining, you know, 50 pounds. 

Mike Koelzer, Host: I never really thought of myself as depressed. I would wake up morning after morning and be anxious.

Mm-hmm and I think I would be depressed because I knew I was gonna feel that way again, it's not a great thing to add that weight on top of that with people. You're 

Lisa Nezneski, PharmD: right. So there are other drugs that are. That impact is less, you know, Wellbutrin well known to be weight neutral. There are several others, but that's the one that comes to mind.

But, um, yeah. Um, again, like I said, you, you, you, this trial and error kind of thing until you find the drug that works for you, and then you realize that you've fixed your life and you don't need that anymore. Yeah. so, if you think of it as a bridge, not a life sentence, or if you really do find you are functioning better on the drug, then don't have any guilt about it.

Just take the [00:35:00] drug. 

Mike Koelzer, Host: There's certainly a stigma. I don't think anybody's terribly embarrassed about needing, you know, cortisone for an arm rash or something like that. Exactly. Or an antibiotic antibiotic for stuff, but there's still a stigma on it. Mental stuff. 

Lisa Nezneski, PharmD: Well, we've come a lot further, you know, than, than in the sixties, when it was all basically hidden in the closet, you know, I have several older relatives that were sort of flatly crazy that right?

That it was a family embarrassment kind of thing. Yeah. And no one wanted to talk about it, nor would they do anything about it, which was even worse. 

Mike Koelzer, Host: Yeah. They wouldn't do anything 

Lisa Nezneski, PharmD: about it. Yeah. So I, you know, it's baby steps, but I think we're all moving in the right direction. 

Mike Koelzer, Host: And then sometimes you think, oh, it's kind of fashionable now to be crazy.

You know what I mean? It's like everybody says they have something, but then it's like, yeah, ignore that as a fashion statement, wait, till they commit suicide, then you got a problem on your hands, you know? So it's like, you can't take that stuff lightly. 

Lisa Nezneski, PharmD: Well, you're right. You're absolutely right. I, I mean, I was reading some things about the epidemic of suicides in kids, you know, the 10 to 16 year.

You know, and maybe it's the social media pressure or something, but, um, it's different than when we were that age. For sure. Yeah. We were a lot more sheltered. They're exposed to so many more things and it, and being in the middle of this pandemic has done a number on people's emotional health, for sure.

Mm-hmm , you know, All the way from kids to grandma's. It doesn't really matter. You know, we've all gone through this and we'll get through it eventually throughout the other side, but it's important to acknowledge that it's going on, you know, that, that we're all sort of going through this and, you know, there's, there's no benefit to just ignoring it, you know, toughing up, you.

That doesn't help. Even 

Mike Koelzer, Host: if somebody can't pinpoint in themself where this pandemic has affected them, sometimes even just the change of routine is enough to add stress to things. 

Lisa Nezneski, PharmD: absolutely. You know, uh, I'm blessed that I've been working from home for the last seven years. You know, it's been a different home.

I've, I've changed five, I've moved five times, but you know, in the last that's stressful, the last two. totally. So, uh, but I pretty much had the same routine, but I wasn. I wasn't connecting with other people. So I, again, felt a sense of isolation. Mm-hmm, because of living alone, working alone, online, you know?

So, um, it was important for me to connect with other people in ways that I could. 

Mike Koelzer, Host: Lisa. Tell me about your certification in mindfulness. What is 

Lisa Nezneski, PharmD: that? I did a two year training program. Was the purveyor Dr. Jack Kornfield and Dr. Tara Brock are the two, uh, PhD psychologists who actually they're.

They're wonderful. 

Mike Koelzer, Host: I like Tara, I've been listening to her. I just listened to one of her podcasts this morning. 

Lisa Nezneski, PharmD: They're an amazing duo. The two of them together, it really was complimentary skills. It was an intensive two years of online training, small group training, and student teaching. So, uh, after, you know, the two years you really come out with a really good foundation to, um, to be a certified mindfulness meditation.

Mike Koelzer, Host: What does that mean? Two years? Like two years of online stuff, you would do something every week. That kind of thing. 

Lisa Nezneski, PharmD: Exactly. That, exactly. That, yeah, it was, it was pretty much entirely online. We didn't really get along, we got together once at the very beginning and this was before the pandemic, you know, the first get together was in, uh, 2019, February of 2019.

And, we finished this in January. So we went for two full years of continuous instruction with, uh, you know, a peer, uh, group and a mentor group. It was an intensive training session, so, wow. Yeah, the best part was the student teaching, you know, actually doing it and, and that's cool. Yeah. Yeah, exactly.

Where 

Mike Koelzer, Host: Do you do that for student teaching? 

Lisa Nezneski, PharmD: Well, the pandemic hit, so we had to all do it online, which was very interesting. So I taught on zoom. Very cool. Yeah. So I'm still teaching meditation on zoom. So that's really cool. 

Mike Koelzer, Host: Yeah. If we go back like 30 years into your life, let's say, okay, would mindfulness and grounding and all that have helped you because I know [00:40:00] you discovered it kind of as something you needed to come out of it, but would it have changed anything?

Going into it or would it still have been the same sucky stuff that happened to you? And you're just maybe rebounded a little bit 

Lisa Nezneski, PharmD: better. Would it have helped me cope? Yes. Yes. Without a doubt, one of my parents was, um, severely, mentally ill. And so I was striving for coping skills most of my life, and I didn't have very good ones.

Mm. And so I definitely. have much more compassion now. And I think that's the key, that the side effects of mindfulness are things like grace and compassion and forgiveness and, and love, and the things that you learn, you know, in Sunday school or in, in catechism or whatever in religion classes. But until you're actually in those positions where, you know, you, you need to give grace.

Having that in your toolbox makes it so much easier, you know, you're much more compassionate. Yeah. 

Mike Koelzer, Host: Probably to yourself and to others. Right. Absolutely. Both probably start with yourself almost well. Yes. True compassion, I guess. 

Lisa Nezneski, PharmD: That's exactly right. Leave yourself off the hook for all these crazy mistakes that you made.

I would mentally beat myself up for things, for sure. For sure. For. Yeah. More than others. Yeah. Yeah. Exa oh, much more than anyone else. Yeah. I mean, cuz I, for, to a certain extent I didn't value their opinion. you know what I thought counted 

Mike Koelzer, Host: more. One of the lines I've heard before is you gotta start treating yourself.

Like you would treat someone that you're caring 

Lisa Nezneski, PharmD: for. That's exactly right. Because you technically, you are. 

Mike Koelzer, Host: So Lisa, we have listeners across the board, but let's say our average listener is, I don't know, 40 year old male, because pharmacy is more slanted female, but we get some of the male listeners. Okay.

So what are you telling a 40 year old male right now? If they're sitting down with you and you don't know a lot about 'em, but they're gonna allow you to impart some of your wisdom onto them. What are you gonna tell them? 

Lisa Nezneski, PharmD: You know, a 40 year old man, um, you know, I've worked with a lot of them. I've raised two sons to be they're in their thirties.

They're not quite 40 yet, but, um, I think the basic 40 year old man is. Driven to success and building a career and really feeling somewhat like half their life is over and they've gotta really prove themselves. So when they look at themselves in the morning, when either they're shaving or they're brushing their teeth when they're really connecting with their own eyes in the mirror in the morning, can they respect that person and the choices that they've made, and if they feel good about their life, then things are gonna flow.

But if they're not feeling good about some of the choices, they need to make some changes and. This would be the time to use some of the techniques of mindfulness to really figure out what's in alignment with their personal core foundation and then moving forward. 

Mike Koelzer, Host: What might be an example of, of a pathway that someone may not feel peaceful with at that age?

Lisa Nezneski, PharmD: Oh, I don't know, like the partner track, you know, I was in, in the big consulting world and, and you had to make partner buy a certain date, you know, and, and there were somewhat artificial, external deadlines put on you. Or you wanna climb the, uh, ladder to some level of management expertise or you feel like you need to get an additional degree, whether that be an MBA or whatever.

Um, but it's, it's a striving and in 

Mike Koelzer, Host: a vacuum, that stuff all sounds great, but you've gotta balance that against your other commitments and your family and your health and all kinds of. 

Lisa Nezneski, PharmD: Exactly. I mean, 40 year old guys probably have a couple of younger children that need their attention. And especially now with, you know, the crazy thing of going to school online and, and, and what sports are being played.

I mean, the kids don't even have an outlet. So having, having a, a. Strong parental figure to help the children through what they're going through. It's so interesting. You never realize as a kid, I just read this, that, um, you know, your parents are growing up while you are too. I 

Mike Koelzer, Host: Remember when I was a kid, you know, going on vacation and stuff where you'd have pictures of yourself [00:45:00] with a campground or something like that.

And it finally hit me like a ton of bricks, like in the last couple years it's like, oh my gosh, my parents might not. Mentally been there. They probably had other stuff. They were thinking they might have been as crazy as I was, but they were physically there at least. Yeah, 

Lisa Nezneski, PharmD: exactly. It's all part of that human condition.

Speaking 

Mike Koelzer, Host: about men in their forties. If you look at a graph of. At what year they try to do this. When they get over the hump of wanting to be president in their company, it's a very similar curve of what age people want to do stuff. And there's some outliers, you know, Colonel Sanders didn't do KFC until he was in his late sixties.

That's why you look at Trump and Biden stuff. I mean, these guys are animals as far as being that old and carrying on those. Day to day tasks and stuff. That's an outlier. It's amazing what those guys do. 

Lisa Nezneski, PharmD: Well, you're right. I mean, I moved to Florida here and, and most of the eligible bachelors are retired.

You know, that's not something that I'm interested in. I'm still, I've still got a lot to contribute, you 

Mike Koelzer, Host: know? So Lisa, the two books they're both available, wherever books are sold. Give us the names of those again. 

Lisa Nezneski, PharmD: Yes. Grounded in chaos that was published on may the. In 2020 in 2021 on May the fourth, seven mindful questions.

I published them both on May the fourth, uh, because, you know, may the fourth be with you. So it's just kind of a fun thing. Was that on purpose? Kind of, yeah, a few years back when I started writing them, I thought wouldn't it be fun to publish them on May the fourth? And it sort of just happened.

Are you a star wars fan, sort of. Yeah. I mean, you know, I saw the original one. What was that? 1977. 

Mike Koelzer, Host: That was a big thing, you know, nowadays with the internet and YouTube and TikTok and all those things. I don't think young. Kids realize what a huge thing that 

Lisa Nezneski, PharmD: was. Yeah, it was enormous. Yeah. That was the same summer that, um, John Belushi did that animal house movie.

Yeah. So it was like a year of unbelievable, uh, cinematic, you know, classics that came out at least for our generation anyway. So, so yeah. Um, may the fourth there's, there's a, a. Uh, workbook that I've just finished. The editor just sent it back to me. And, uh, so all of the exercises and meditations, and there's some new poems in, uh, the workbook.

But if you really want to learn the seven mindful questions, the workbook companion, uh, will really help you go through the exercises and understand at a level. Uh, to, to begin to incorporate them every single day into your life, which is really what I, I, I would be most thrilled if that happened. 

Mike Koelzer, Host: I've got that habit of focusing, you know, and of control.

And along with it comes the anxiety and stuff, and it's like, well, why not? I'm really focused and I'm gonna get that done, but there's a big, beautiful creation out there. And when your focus is so small, there's so much you're. We don't have to concentrate that hard on things. 

Lisa Nezneski, PharmD: Well, you know, give yourself some grace because concentration is the doorway into meditation.

And doing, uh, you know, a few minutes of meditation each day helps you reset and change your perspective on your life, gives you the space for better ideas to come in. So, yeah, concentration, I'm a big proponent. Yeah, but it's also 

Mike Koelzer, Host: the doorway to four bowls of honey bunches of votes at night, 

Lisa Nezneski, PharmD: too. No. Think about that.

Were you really concentrating or were you deflecting or were you doing a behavior that took you away from what it was that was really bothering you? Yes, 

Mike Koelzer, Host: you're exactly right. What I'm trying to do now through leaders like you is to say, wait a minute, here comes the wave, relax. Open up, let it be there.

Concentrate. Where are you feeling this in your body? Concentrate on it. Give yourself some grace. That's the concentration. You're exactly right. What I was doing was deflecting it because it was a little painful to feel that adrenaline running through me. So I'm not concentrating on it. I'm deflecting what I was tied up with earlier.

Lisa Nezneski, PharmD: Exactly. Exactly. Because all behavior's purposeful question number two, the, because why are, why am I doing [00:50:00] this? You know, what am I doing for the benefit? Or am I doing it to deflect myself from feeling like you said, it's 

Mike Koelzer, Host: hard to feel sometimes though. 

Lisa Nezneski, PharmD: Oh gosh. But feeling is why we're here on this earth.

We are here to feel. Feel connected to one another, feel love, feel God's love. We are here to feel. When 

Mike Koelzer, Host: You grew up, we all get to blame our parents. That's the fun part about growing up. And my kids are gonna blame me too. My kids, they're gonna keep all kinds of therapists in business for years. I just know it, but now it's my turn.

We get to blame. Our parents sing as kids. We weren't really allowed to feel those emotions and so on. And you were taught. Get rid of the emotion. 

Lisa Nezneski, PharmD: Yeah, you weren't to embarrass them. Kids were to be seen and not heard, that's right. Kids. Weren't supposed to cry in public, you know, all these things, you know, I'll give you something to cry about.

Mike Koelzer, Host: So you tie up the emotions and now finally you feel 'em and they're kind of painful. I don't mean painful. Like, I don't wanna think back to this terrible time of life. I'm not talking about that kind of pain. I'm just talking sometimes about the pain of. Feeling like the everyday stuff, everyday stuff. Just like feeling adrenaline, like feeling uncertainty or a little bit of sadness or something, just simple emotions like that can be painful.

Lisa Nezneski, PharmD: Well, it can, and we're finding that allowing ourselves to be vulnerable. to feel those feelings, which is really what you're saying is, is how painful it is. You you're. You're allowing yourself some vulnerability and. To recognize that there's gotta be a safe place for that. And whether that's at home, you know, you don't wanna be Boohoo in, I used to tell this nurse that worked for me.

You cannot cry at work. That's right. She's but she's wonderful. You know, a compassionate person is, but my point is, you know, having, having some good person that you can pick up the phone and say, you know, Mike, if you ever wanted to call me, you've got my phone number. Yeah. I will listen to you. You need someone to listen to you, then I will be there for you.

Yeah. So having someone that you connect with is really important, or even, you know, nowadays they've got these, you know, rent a therapist, You could have some anonymous person listen to your feelings. I mean, there's a lot more options, but, um, yeah. Create for yourself those connections where you can have that vulnerability and people will love and support you through that.

Mike Koelzer, Host: Yeah. That's where that grounding comes in. You know, feeling safe. It's important to find somebody that will listen and let you feel. And. Tell you to get rid of those 

Lisa Nezneski, PharmD: feelings and validates that that is a real feeling. 

Mike Koelzer, Host: Sometimes we can even get embarrassed of our feelings and it's like, well, that's okay.

You know, you don't have to compare your feelings to somebody else. There's plenty of verbal explanations to go around. It's not a competition, it's not a competition. It's not a competition of seeing who had it worse or whose feelings are worse. If you have feelings. it's okay to talk about 'em hold them 

Lisa Nezneski, PharmD: tenderly in your 

Mike Koelzer, Host: heart.

I don't know. Sometimes cereal still feels better.

Lisa Nezneski, PharmD: all right. Well, just limit yourself to one bowl and you'll feel better. That's hard to do. 

Mike Koelzer, Host: Yeah. Well, Lisa, such a pleasure talking to you. Thanks for all you're doing. I encourage everybody to go onto Amazon. Look up grounded in chaos. That's Lisa's first book that came out on May the fourth and also seven mindful questions, which is.

This year's book is on May the fourth. Is there gonna be a, uh, a trilogy like Star wars? 

Lisa Nezneski, PharmD: I should do that. Shouldn't I? Yes. I actually have one more book already written in the can. I just need to edit it. So, yeah. That's yeah, that's entirely possible. You've got seven 

Mike Koelzer, Host: months or whatever. Come on. That's right.

Top to it. All right, Lisa. Thanks. 

Lisa Nezneski, PharmD: Thank you so much, Mike. This was wonderful. Thank you.