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Dr. Jones: Great expectations. I'm talking about your Valentine's Day hopes. How can you manage your expectations? How can you get what you want, or want what you get? This is Dr. Kirtly Jones from Obstetrics and Gynecology at the University of Utah Health Care and this is The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: You've seen the YouTube videos, those ones with the guys who do some extraordinary surprise thing for their honey. Pay a plane to drag declarations of their love across the sky. Buy a ticket for a plane ride to an amazing location. You know, give a bouquet of roses as big as a car. Valentine's Day, or your birthday, or your anniversary, these special occasions can set us up for great joy and satisfaction, or great disappointment. How does a grown-up manage wants and expectations around these times?

First of all, the trauma probably started, for those of us who grew up in less enlightened times, when we were in first grade. You know, we all made little shoeboxes with our names on them and our moms bought the little Valentine's and we picked out our friends, or our want-to-be friends, and put Valentine's in their boxes. We all had hopes to get a special valentine or the hugest batch of valentines. And we often didn't and it got worse from there. So here's the problem.

One, women often think, "If he loved me, he would know what I want for Valentine's Day." Two, it's more romantic if it's a big surprise. Three, "It's my Valentine's Day; he should plan it. It's about me." Four, if he doesn't do whatever, he doesn't care about me. Five, guys only want one thing for Valentine's Day.

Well, here are the solutions. He, or she, probably just wants you to be happy. At least, that's the right place to start. If you love them, don't set them up for failure by making them read your mind. Be a grown-up. Grown-ups are responsible for their own happiness. Ask for what you want. Don't set your partner up for failure, set them, and yourself, up for success. The surprise thing, that's a mistake. They overblow it and they blew your budget. They do too much and you don't really like them that much. They don't do enough and you're disappointed. Surprises are overrated.

Now, it isn't "my" Valentine's Day, it's "our" Valentine's Day. Let them know what you think would be nice for you to do together for Valentine's Day. Ask what they would like. Yes, maybe some guys only expect one thing on Valentine's, but don't assume. There may be a lot of pressure on both of you to figure out the right thing and all that could be modified if you just ask.

If you don't have a Valentine's date, you can just mope or you could do something nice for someone. Try some guerrilla goodness. Send a card or a note, not too overbearing, to someone who might not be expecting it. It makes two people feel good, you and them. Of course, you can send more than one. I might do that even though I have a Valentine.

Now, about my valentine. Thirty-five years ago I went into therapy with a highly-respected psychiatrist at a highly-respected medical school. My issue was, why hadn't I left this guy after seven years, who forgot Valentine's Day and my birthday year after year? I wept. Certainly he didn't care for me. She looked at me and let me have my rant. Then she gently suggested that if I was a mature person, I would ask for what I wanted and not set him up to fail year after year. If I loved him, I wouldn't expect the impossible, and I wouldn't set him up to fail.

Huh, that was the best money and time I'd ever spent. We've had 43 Valentine's Days together. Thirty-five years ago, I let go of expectations. So this year, I will get what I want and want what I get. It goes sort of like this: "What would you like to do for Valentine's Day? I would like to go out for dinner, just the two of us, to someplace yummy. It doesn't have to be exactly on Valentine's Day, just sometime this month, my treat." Happy Valentine's and thanks for joining us on The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Announcer: Questions every woman wonders about her health, body, and mind. This is, "Am I Normal?" on The Scope.

Dr. Jones: There are very sad things that happen in some... in everyone's life. We are all going to go through a time where we experience grief because of either a situation or a loss of a loved one. I am a fertility doctor and I see women who are trying desperately to have a child and they are working at it everyday, and they're taking their temperature, or they're taking medicines. And they are tearful everyday because everyday in our community here in Salt Lake, you're reminded that you're not a mother because there are children and babies everywhere.

So, the question is, what's going on in your life, and is this something that you're having difficulty managing? There's acute grief. There's chronic grief. There's depression and there's sentimental. So, chronic grief is an ongoing reminder that something is bad in your life. So, I think my infertility patients are the most likely and understandably to be tearful most days when they're reminded everyday by both their therapy or by their environment that they're struggling and not succeeding. There are ways to help you deal with that. And I think that if it is interfering with your day-to-day life, your therapy or your relationship, that kind of chronic sadness over situations, can be helped.

There's acute sadness, as in grief of a loss of a loved one. You get about six weeks so that you're not crying everyday and six months before you're back to yourself. If you aren't back to yourself in six months, that's what we call complicated grief. And that's where therapy would be important. So, crying everyday over the loss of your son or the loss of your parent after six months is a complicated grief and that's where therapy or even medication would be indicated.

So we have people who are situationally sad. Their character and their biology is healthy, but the situation is awful and it keeps being reminded how awful it is. There is a situation's acutely awful, but you get over it and that's acute grief.

There are people who cry everyday for no particularly good reason, who are truly sad. And if you are tearful everyday over activities that are normal in your life, that may be depression. And that's not normal and it is treatable. I think here in Utah, we tend sometimes to go to medicines first, but there's some very good evidence that behavioral therapy works as well as medicine and it's probably more sustaining in the long run.

So, if you're feeling hopeless, helpless, sad, and tearful, you get no joy from day-to-day life, you've noticed that you've lost your appetite, or maybe you're eating a lot, you're not sleeping well and you're tearful all the time for not any acute, new reason, that's very likely to be depression and some kind of intervention is indicated.

Then, there is what I call sensitive or sentimental. So, on any given day, I would say, I tear up because I see something that makes my heart soft. It might be a McDonald's commercial with kids in it, or it might be seeing a child, and it usually has something to do with children or animals, where I become tearful. And it's because my heart feels full. Human beings may be the only species that cries. And why in the world would we cry? Well, crying is a way of letting others in our community know that we are emotionally full, and it might be sad. I tend to cry when I get angry as well. I cry when I'm sentimental. So, we use tears to advertise our inner state. No other animal really cries. Animals do cry out, meaning they vocalize their unhappiness. And a dog can be horribly, horribly unhappy, but they don't cry tears.

So, tears are an advertisement that's uniquely human. So, we may become tearful because we are offered up in a Madison Avenue, slick way something that's very sentimental. It pushes our buttons. And sure enough we will tear up, not that we're sad, but we're feeling that our hearts are full or we're sentimental.

Now, women are more likely to tear up than men, because we may be more sensitive to emotional states biologically. We certainly are more likely to tear up culturally. Men are told not to cry. Big boys don't cry. So, they are less likely to be tearful. This coming Father's Day, we'll see when that beautiful card that the three-year-old made for Daddy if the daddy tears up a little, not because he's sad, not because he's depressed, but because he's feeling sentimental.

So, that's the skinny about tears. There're good tears of happiness, tears of being sentimental. There are bad tears, I think, of rage. There are complex tears because you've lost something important. And complex grief or crying for no good reason that isn't sentimental, we can help out, here at University of Utah Health.

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updated: July 5, 2018
originally published: November 6, 2014

Dr. Jones: Are you angry? Are you sad? Are you anxious? If you can say yes to any of these, does it mean you're not well emotionally? What does it mean to be emotionally healthy and how does it fit into the seven domains of health that create an overall sense of well being? This is Dr. Kirtly Jones from the Department of Obstetrics and Gynecology at University of Utah Health Care, and today, we're talking about what it means to be emotionally healthy on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you can use, for a happier and healthier life. You're listening to The Scope.

Dr. Jones: Women have told us that their sense of personal health goes beyond their blood pressure and their mammogram. They tell us things like, "You're only as happy as your least happy child." They tell us they feel their emotions in a physical way. They tell us that some of their physical symptoms may because of stress. Well, wellness can be sorted into the seven domains: physical health, emotional health, social health, intellectual health, financial health, and spiritual health. Today, on The Scope, we're going to talk about what it means to be emotionally healthy. You can feel happy, sad, anxious, and angry, and be emotionally healthy.

Being emotionally healthy means being aware of your emotions and how they affect you and others. It means being attentive to your thoughts, and feelings, and behaviors whether they're positive or negative. It implies the ability to accept our feelings rather than deny them. Being emotionally healthy means that you take a positive attitude about your ability to acknowledge your emotions. You feel that you can make choices and decisions based on a synthesis of your feelings, thoughts, and behaviors, rather than behaving in an immediate and reactive way to your emotions. Being emotionally healthy means you can take on challenges and take risks, and recognize conflict as being potentially healthy. This is particularly difficult for women, who may be culturally taught to say, "yes," when they really mean "no."

Being emotionally healthy means being resilient, bouncing back in the face of personal and family trials and sadness, recognizing that bad times come, bad things happen, but that you have the emotional stability to return to equanimity. So a lot of medical focus on emotional health in the past 50 years has been on psychological disease, its diagnosis and treatment. This has been important, but in the past 20 years, some have focused on what it means to be emotionally well. What are the characteristics of people who are emotionally well, and what can be done to make people more than not sick?

The path to emotional wellness may involve awareness of thoughts and feelings. Using a positive attitude and recognizing your signature strengths, seeking support and expressing emotions in a suitable manor, setting priorities, accepting mistakes and learning from them. So, do you want to evaluate your own emotional wellness with a brief quiz? Number one, am I able to recognize my emotional states and how it affects me and those around me? Two, am I able to maintain a balance of work, family, friends, and other obligations? Three, do I have ways to reduce stress in my life? Four, am I able to make decisions with a minimum of stress and worry. And five, am I able to set priorities?

Now, if you're really interested in emotional wellness, and where you fall compared to other people of your sex and age and geographic location, people from New York City may respond differently to a questionnaire than people from Iowa, take some time and Google "authentic happiness University of Pennsylvania." This website, from the University of Pennsylvania, is part of a larger program to research, teach, and evaluate the field of positive psychology. Now there are some very specific activities that can increase your sense of emotional well being, that have been studied with scientific rigor, prospective randomized trials. Try two of these. One, write down, every day at bedtime, three things that went well and why. Two, be grateful in an active way. Think of someone who has done something for you, that you haven't thanked recently. Write 300 words of thanks to this person and deliver it personally, out loud or in writing. So here it goes.

Dear Scott, who is the producer of The Scope, in less than 300 words, I am grateful for this opportunity to talk about something that has gone well today. Thanks so much for letting me talk about the seven domains of health, and for making me and my voice sound better than they really are. And thanks to you, listener, for joining us on the Scope.

Announcer: We're your daily dose of science, conversation, medicine. This is the Scope, University of Utah Health Sciences Radio.