Doctors and Mental Health

The lives of medical professionals (at least the part of our lives that we choose to share with the public) are a lot like Instagram posts: lots of happy, successful moments to build the image of being competent and caring. But just like Instagram, real life is never as perfect as that carefully curated snapshot.

If you remember my last post about the things we don’t talk about, there was one really important topic I left off that list:  mental health. Just like physical health, our psychological well-being is integral to the way we function. But while we won’t hesitate to get ourselves checked at the first sign of illness, we balk at the idea of talking about our feelings or worse, spending time in therapy.

Sometimes we don’t talk about it because we feel our patients need to believe that their doctor is operating at peak performance. Discussing our mental health issues openly, or even acknowledging them can have a detrimental impact on the physician-patient relationship. Patients tend to think of doctors as superhuman, somehow immune to the struggles that plague the average person. In reality, doctors have the same problems as everyone else. But we don’t like to be reminded of that. We buy into the con, believing that we are somehow capable of feats no one else can do.

Sometimes that’s allowed, even expected – not everyone can perform brain surgery or resuscitate newborn babies – but other times we overreach. Doctors frequently pull stunts like trying to function normally after 36-48 hours with no sleep. We sweep treatable issues like depression under the rug because of course we can handle it, self-medicating with substance use or else ignoring the problem entirely until it can no longer be contained.

The medical profession carries one of the highest rates of suicide (1.4-2.3 times the rate of the general population). But discussing an issue that can call into question your fitness to practice is absolutely off-limits. In the most ideal and ethical situation, doctors would put the patient’s interest ahead of their own security, but we are human first, driven by the same fears and needs as everyone else. And there is a very real fear that any perceived disability will end or permanently blight our careers.

On top of this is the associated stigma of mental illness that is so very rampant in Jamaica and the Caribbean. No patient wants to see the “mad” doctor who “tried to kill himself”. But if any progress is to be made in erasing this stigma we physicians have to be the pioneers. And since this stigma persists even among doctors, we are the first hurdle we have to clear. After that, education and sensitization of the wider society.

Even though no one seems ready to talk about it* (Megz over at Barefoot Medz is one of the few, doing a really great job) mental health is a discussion we need to have. In such an emotionally draining and psychologically demanding profession it isn’t fair to anyone to have doctors fumbling to look after their mental health alone.

We need to catch mental health issues among physicians from early, as early as medical school even. Mandatory psychological screening for depression, anxiety and PTSD among others should be instituted for all the high risk professions: doctors, police officers, firefighters. We shouldn’t have to wait until a doctor commits suicide or a policeman kills his spouse before doing something. Prevention or at least early detection is paramount.

There’s a lot of work to be done. Efforts have started but they’re halfhearted at best and the government offers little in the way of support. We must be our own advocates and work with other key players to remind the public that there is no good health without good mental health.

*

Further reading: a pediatrician’s experience with psychosis, and a GP’s experience with depression.

*After writing this post, I discovered Dr. Eric Levi an ENT surgeon who is also making strides in the discussion on mental health in doctors. 

Advertisements

Advice from Someone Deeply Rooted

treefeetI think everyone gets bad moods. The blues (or the reds) or whatever you want to call them. Sometimes I slide down an emotional slope, and sometimes it’s really hard to get back out. Honestly, I’ve a long history of unhealthy behaviour when it comes to dealing with my funks. But sometimes I surprise myself.

Exercise helps, right? Ask anyone. ‘Endorphins’ is the buzzword. I like to walk, especially along scenic routes. The Hip Strip in Mobay has its faults but it’s still got an amazing, totally quintessential, tropical view of the sea. Staring off into the horizon usually does a lot for my peace of mind, more so when it’s lit up with sunset reds. keanequote

There is a park on Bottom Road at the site of the Old Hospital.  I almost always walk through this park, most times without even thinking about it. Walk through, I heard myself say, in response to Kat’s question. So we did. Find a bench.

Now if you know anything about the Old Hospital Park, it is that it’s littered with lovers on a bad day. On a good day, a non-rainy day, there are no corners free from necking, cuddling and schmoozing. I saw a bench occupied by a lovey-dovey couple.

Not that one. That one.

An empty bench. I sat and Kat (probably by this time out of his depth with my moods) followed suit. Deep breaths. Lie down. Look up.

And there it was, this tree: tree1

And because my brain just can’t leave good enough alone, I overthought. And what I came up with was this.

That tree has all these concentric rings, going up. Growth rings, like the ones on the insides of other trees. And the ones at the top were the brightest, but also the narrowest. Brand new. The ones at the bottom, closest to the roots were faded and stretched with age. I though the tree was trying to tell me something and what I thought it was saying was this.

Your actions don’t fade. What you do lives on stronger than you ever will. The marks you make at the beginning, at the start will fade, but the foundation they create won’t. Your circles disappear into the trunk of the tree of time, grounding all those branches and leaves. The tree was telling me, your scars will forge a path for new growth. Your scars will be the birthplace of beauty.

I’m overthinking it, right? Not yet.

Because I saw this other tree: tree2

And I was just so moved by the way it flaunted its orange. I mean, it’s a tree, it probably doesn’t have a choice. But trees lose branches all the time. They just drop off when they’re no use. So maybe this orange branch, this sore thumb, was doing something good up there. And the rest of the tree kept it around. Embraced it. Embrace your orange, that tree was telling me.

Is it significant that I hate the colour orange? Telling me to embrace it is like telling me to love all the ugly parts of me. All the parts I hate. Love them anyway.

Am I overthinking things?

Probably.

Trees aren’t really known for being this chatty.

Vulnerability makes me uncomfortable but people are kind of amazing

The Bloggess wrote a not-funny post about feeling like crap most of the time, and asked people to honestly  share how many days out of the month they felt like they were kicking ass. My memory is inherently faulty, though. On the days when I feel like crap, I think I feel like crap 98.98793% of the time. On the days where things are okay, I think I’m okay 98.98793% of the time. One of the reasons for this is actually Jenny’s mantra: depression lies.

One of the comments she got was from this guy and this is what he said:

You spend real time with your daughter every day. That right there is amazing. It’s not “curing Lupus” amazing. It’s not “dunking a basketball … that’s ON FIRE” amazing. But few things are. Few people mow their lawns, pay their bills, read the paper, and eat breakfast all in one day. Most people don’t change the kitty litter, walk the dogs, go to work, spend time with their kids, AND don’t owe their parents money.

Seems like the bar that we measure amazing keeps getting higher and higher every year. Anything that smacks of weakness is just so GROSS, isn’t it? I mean, we’re meant to be these beings who are completely in touch with our emotions, yet in total control of them, yet express them whenever we are supposed to, but only in the correct way, and the correct way is sometimes killing bad guys. Like Romulans, Klingons, and Vulcans, all rolled into one person.

Those people don’t exist. Albert Einstein wasn’t that person. Have you seen that photograph of his desk taken the day he died? It was a MESS. His marriage fell apart. The man was a disaster. A brilliant, beautiful disaster. One of those disasters that streaks across the night sky, so amazingly, serenely gorgeous in its descent, that we can’t help but watch as it makes its lovely way before it plops right into the horizon. There it remains, indelibly marked on our landscape, right above the dashboard, just below the mirror.

Truth is, none of us can offer you sage advice or candid disclosure beyond to say that we are enjoying watching you arc. Amazingly, gracefully, like a metal rooster, stuffed with dead animals, streaking across the night sky, totally on fire.

Once a week, you are successful.

Typically, whenever you talk to us.

Hands down, his was my absolute favourite answer. He wasn’t just trying to appease her with platitudes or sharing his own burden without speaking to what she had said. He listened, and he replied, sans BS. And it was pretty.

I want to give this man a hug. In lieu of creepy hugs from total strangers, I will send him readers.

Sally forth, my intrepid readership. His name is Craig Norton and the post explaining how to get banks to stop calling you is absolute genius.