Feeling anxious, flat, or stretched too thin doesn’t always mean something is wrong with you. Sometimes it’s a signal, and the question worth asking is what it’s pointing to.
In this episode of the Her Health™ Podcast, Dr Siobhan Dawson, a specialist integrative psychiatrist with an open, holistic view of mental health, explored exactly that.
From the biology beneath anxiety and depression to life transitions, sleep, and movement, she looked at what it takes to feel well, not just manage symptoms.
Rapid Fire: What Affects Mental Health, Rated
We asked Dr Siobhan to rate common factors from zero (very negative effect on mental health) to 10 (very positive effect):
- Social media – 6/10: Not inherently bad, but the way it’s used can be very problematic.
- Connectivity – 9–10/10: Community and reduced isolation are key to wellbeing.
- Creativity – 6–7/10: It builds an appreciation of how you take from the world and give back to it.
- Grounding (walking barefoot in nature) – 4–5/10: Some science, not yet evidence-based.
- Sleep – 10/10: Disrupted sleep and psychiatric illness feed into each other.
- Exercise – 8/10: Movement in any form is critical.
- Alcohol – 2–3/10: Known as an anxiolytic, but its disruption to the brain and sleep is significant.
From Pathology to Ecology – Her Path into Psychiatry
Dr Siobhan opened with her own story. She had always wanted to be a dancer, but came from a long line of medics, and psychiatry won because of a love for people’s stories. Early in her training, she felt unsettled by the revolving door of patients who were treated but not flourishing. Her father’s cancer diagnosis became a turning point, and she taught herself integrative and functional medicine.
Her position was clear:
“I’m not anti-psychiatry. I’m not anti-medication. I think everything has its place.”
But she believes psychiatry has to be bigger. Medicine is excellent at finding pathology and delivering precise interventions. Dr Siobhan noted that it could be better at helping people feel well and thrive.
The Layered Cake – What She Looks at First
Dr Siobhan described her approach as a layered cake, with each layer adding to the picture of what is going on for a person.
The first layer is risk. Before anything else, she assesses how significant and disabling the symptoms are. Next comes the diagnostic label, which she explained is most useful when speaking to other clinicians. Some people find a label helpful, others don’t, and either way a diagnosis is really just the recognition of a pattern, not the full story.
Underneath sits the biology the brain lives in. Thyroid function, B12, iron, and inflammation are the usual starting points, but she also looks at mitochondrial function, metabolic regulation, and circadian rhythm. The brain is in constant communication with the body, so what happens in one directly shapes the other.
Above that is the person’s life. She asks what their nervous system is experiencing: cognitive overload, a caregiving burden, isolation, or work that no longer feels meaningful. She also asks whether the anxiety is actually a healthy response to what is happening in their life.
This is why emotions like sadness and anxiety feel brain-based but are rarely only that. Depression can look like anhedonia, fatigue, and poor concentration in one person, and feel wired and tearful in another. Different components drive different symptom packages, which means two people with the same label can need very different support.
Risk always comes first. But symptoms carry information, and listening to it is part of the work.
Symptom or Disorder? How to Tell the Difference
Not every difficult feeling is a disorder. Dr Siobhan pointed out that we’ve become sterilised in our tolerance for the full range of human emotion, and she offered a useful way to think about it:
“If somebody touches a hot surface and retracts their hand because of pain, pain isn’t the disorder. It’s a signal.”
She explained that the questions worth asking are whether the suffering is proportionate to what’s happening, whether it’s flexible (are there moments of relief?), and whether it’s causing significant dysfunction (suicidality or alcoholism). Grief after a loss is healthy. Dissatisfaction can be the friction that shows a path is no longer fulfilling.
Life Transitions – Recognising the In-Between Spaces
She explained that the word psychiatry comes from the Greek for soul and healing, and that every major life transition brings psychological shifts alongside the biological ones. Menopause is one example. Treating it as purely hormonal is reductionist. In a life stage, something has to dissolve before something new emerges, and the western world rarely offers a container for that in-between space.
The Five Rs – Looking After Your Mental Health
Dr Siobhan outlined her “five Rs” as a framework for the depleted, overstimulated woman:
- Rhythm – waking early, getting daylight, and limiting light pollution in the evening, because circadian rhythm is key for every cell in the body
- Running/Movement – a cornerstone of mental health, and goes beyond just doing yoga when you are anxious
- Restoring connection to nature – a walk outside or a swim can sometimes beat the gym
- Reawakening – what brings aliveness, play, curiosity, and wonder?
- Remove – focusing on what is detracting from one’s life and removing it from the picture, rather than introducing another new tool
Coming Off Medication – Her Personal Story
Dr Siobhan spoke openly about her own experience. After a traumatic incident, she was on antidepressants and sleeping tablets for seven years and lived with PTSD. While travelling through South America, she took part in an ayahuasca ceremony in the Amazon. Staying with the shamans meant stopping her medication, and she never went back to it.
She described the experience as a deeply restorative recalibration, and as a break from a belief she had been carrying.
It left her seeing her life with more neutrality and positivity and gave her “a depth of connection to what I would call my soul.” The shaman she spoke to afterwards told her that she should return to London, finish her degree, and work within psychiatry to change the paradigm.
She was equally clear about the limits of her story.
“It’s not necessarily a guarantee. It is also dangerous to just suggest that people can go out to the jungle and take plant medicines.”
On coming off antidepressants more generally, she was direct that it’s a conversation for a clinician. Weaning yourself off antidepressants without support after being on them for years and years is challenging and should always be supervised.
One Tip Everyone Can Start Today
“What’s important to think about is what will change my immediate state, but what might also allow me to restore my health longer term.”
Dr Siobhan gave a simple example. An immediate fix might be a sleeping tablet or a coffee. A more restorative choice might be a walk in nature or picking up the phone to connect with a friend.
Feeling well isn’t about a longer list of wellness tasks. As Dr Siobhan Dawson reminded us on this episode, it starts with understanding what is depleted, what is oversaturated, and what can be taken away. Symptoms are signals worth listening to.
💬 Interested to hear more on psychiatry and mental health? Check out the episode with Dr Jessica Stanbridge here.
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If you’re struggling, support is available. The South African Depression and Anxiety Group (SADAG) offers support and referrals on 0800 456 789 or at sadag.org.
This content is for informational purposes only and does not constitute medical advice. Always consult with your healthcare provider or a qualified mental health professional before making any changes to your treatment, including starting, changing, or stopping any medication or supplement. This unregistered medicine has not been evaluated by SAHPRA for its quality, safety or intended use. If symptoms persist, consult your healthcare provider.
