Monday 27 November 2017

Mental Health Stigma: A Doctor Who Has Been in Your Shoes

Your doctor may relate to your mental health concerns more than he or she can say.

Imagine you are sitting with your primary care doctor sharing your symptoms of depression, anxiety, ADHD or anorexia. Imagine in that difficult and lonely moment, your doctor makes the decision to self-disclose that she not only understands your symptoms from a professional standpoint, but also personally as someone who also struggles with a similar diagnosis. What would you think?

My friend Eliza just finished her medical residency and explains that this scenario has played out in her head plenty of times, but never in person. She explains that thus far she hasn’t felt that it was information that would support patients in ways she couldn’t achieve otherwise. However, she says that her struggles are a large part of what makes her an effective provider. “Yes, suffering from some of these mental health disorders can make it more difficult to discern and compartmentalize and not project things on my patients, but I am better at treating psychological issues than many of my peers who have never encountered them outside a professional setting. I’m really familiar with the drugs and things that can go wrong and the side effects, because I’ve been through them. You could call it an unpleasant firsthand learning experience.”  

Eliza talks about how her depression and recovery from anorexia allows her to empathize with people more deeply than she otherwise would be able to. Her anxiety makes her really productive. Her ADHD makes her more creative, allows her to multitask and look at things differently than most. She explains that her personal experience with mental health disorders make her a better doctor, however the stigma around mental health in the field can be very problematic. “Some people view it as a choice or illegitimate. When someone suffers a bout of major depression, people are expected to push through it. That has to change. It’s detrimental when we force people to tough it out. Especially in my field because I will put that on my patients.”

When Eliza decided to apply to medical school she did a lot of investigating into whether or not to disclose her personal experiences. She recalls reading about how applications to med school should be as personal as possible. She read a testimony online where an applicant was talking about having bipolar and being hospitalized and why it would make her a better physician. Eliza still remembers that the overwhelming response from peers was “NO NO NO. Do not share this. You will not get in.” Eliza admits she chose to only self-disclose to a few close friends in her program.

She talks about how challenging and dark it got during school and how important conversations with understanding experts were. She recalls a very affirming conversation with the disability program manager at her school, who explained her ADHD diagnosis to her better than she had ever heard before. “People think that people with ADHD are paying attention to a million things at once because you can’t pay attention to anything… but your brain just needs a certain/higher threshold to be able to lock in and tune in.” After this conversation she stopped buying the textbooks that she couldn’t focus on and started constructing her own adaptive techniques to learn the material. “I got through school because of my iPad and foam roller. I would watch videos on the floor while foam rolling and I realized that once I had visual, auditory, and body movement I could actually recall information.”.

Eliza knows how her mental health and sense of safety to confront stigma ebbs and flows, but she says now, having finished school she feels fiercely about advocating for herself and her patients. When I asked her what her aspirations are for her career she responded proudly, “Hopefully crazy attracts crazy.”



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