Manisha’s Take

This topic is very personal to me. I first felt depressed when I started college. I had left my home in Indiana to travel to Massachusetts, where I didn’t know anyone at Wellesley College. Anxiety hit for the first time the year after I graduated. I had started working at an investment bank in New York City—no doubt a stressful environment—with hopes of getting into Harvard Business School, which I did.

Over the ensuing 25 years, my symptoms got exponentially worse. There would be periods when I’d be really “on”; I could get off a plane at 9 p.m., go straight to the office and work until 1 or 2 p.m., return home for a brief shower, and be ready to do it all over again the next day. Neither I nor anyone around me thought this behavior was odd. In the world of finance in which I lived, 90-hour workweeks were “normal.” Weekends were simply more time to work.

And because I was completely devoted to my profession, the achievements were many and significant. Any assessment of my career—from building out a $6 billion account business to co-authoring two best-selling personal finance books to becoming a leading voice on issues of financial literacy and female empowerment—would show my outward success.

But eventually, I’d crash and hit a wall. I’d experience extreme bouts of crying combined with an inability to get out of bed and, in the worst times, a lack of desire to even be on the planet. This was my “normal.” I sought to rationalize it or insist it would pass. And like so many who struggle with mental health issues, I managed to hide it all at work. Never once did I fall apart in a client meeting, while giving a speech, out in front of the media, or any other public setting. I got so good at it that, like a light switch, I could turn on my “happy face” when needed and then privately I’d go home and collapse.

After getting divorced, moving to a new city, and fortuitously being referred to a psychiatrist who I saw regularly, I was finally diagnosed with bipolar II. Today, I am on a “cocktail” of medications consisting of anti-depressants, an anti-anxiety, and an atypical antipsychotic. I supplement these medications with regular sessions at Revocycle and other forms of high-intensity exercise.

Why am I telling you all this? Because if you or someone you love is struggling with mental health, I want you to know:

1. Mental health issues can be situational, chemical, or a combination of both. They occur along a spectrum, and each person’s experience will be different.
2. Navigating the mental health system can be very difficult. Most people start by talking to their general physician, who gives them anti-depressants and/or anti-anxiety medications, and that’s that. For a lucky few, that’s enough. For others, that’s not nearly enough.
3. Identifying the root cause is vital. For situational struggles, talk therapy, cognitive behavioral therapy, or other non-pharmaceutical treatments can help. If the source is purely chemical, you may need a psychiatrist to work with you on medications and dosage.
4. Countless “successful” people struggle with mental illness. So know that mental health issues don’t preclude a highly productive and enjoyable) life, if properly treated. But you have to talk about it first—to the right people—to get the help you need.

I found Michael Hosking and Revocycle, and it has been a fantastic source of relief in so many ways. But my story is but one story. Mental health issues are real, debilitating, and more common than you might think. Each person’s experience is different, yet there is always hope and help. It’s time to normalize discussions of mental health so people can get the proper care and treatment necessary to lead full, vibrant lives.

Manisha’s Top Takeaways

1. Exercise supports mental health by tamping down the HPA axis, which is the source of the stress response.
   The hypothalamic–pituitary–adrenal (HPA) axis is where the body’s physical response to stress kicks in. Of course, it’s vital when you’re facing life or death situations. But when it’s always stuck in the “on” mode, it wreaks havoc on the body. Exercise helps calm that response. [9:15]
2. Exercise triggers neurogenesis, which is associated with a reduction in depressive symptoms.
   When we exercise, we develop new neurons in the brain’s hippocampus region. And it requires as little as 20 to 30 minutes of high-intensity exercise. It turns out that oft-quoted “prescription” for health has a real scientific basis. [10:50]
3. The cause of “runner’s high” may be cannabinoids, not endorphins
   It’s often said that you feel great after a workout because you’re “endorphins have kicked in.” However, endorphin molecules might be too large to make it through the blood-brain barrier. Recent research seems to point to the concurrent production of cannabinoids as the dynamic driving that high. [14:00]

Other Major Topics

1. What makes mental health issues so difficult to diagnose and treat [3:30]
2. The surprising outcome of Dr. Hosking’s use of small baby steps [7:00]
3. What is the right “dose” of exercise to support mental health? [17:30]

Resources Cited in the Episode

1. Michael Hosking’s cycling program and studio, Revocycle
2. “Why Exercise May Be the Best Fix for Depression,” The Scientific American
3. Brain & Behavior Research Foundation
4. National Alliance on Mental Illness
5. Manisha speaking about her mental health diagnosis and how she’s grown from it
6. Books on mental health: An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison; Darkness Visible: A Memoir of Madness by William Styron; The Noonday Demon: An Atlas of Depression by Andrew Solomon
7. 20 Great Historical Figures Who Struggled with Mental Illness, History Collection
8. “Exercise May Boost Mood for Women With Depression. Having a Coach May Help.” The New York Times

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