State of Mind

One has a greater sense of degradation after an interview with a doctor than from any human experience.~ Alice James

I bet that those who read the above can identify with the sentiment. Even the advertisements on television try to make asking a doctor questions seem like a pleasant and worthwhile experience. Medical practices use catchy phrases, colorful logos and photogenic people to entice the public to come see them. Haven’t you ever wondered why a profession that has been deemed “necessary” to modern man needs to spend so much effort on its public image?

I’ll come right out and state that I don’t believe physicians as a group desire to do harm. I believe they genuinely want to be helpful. Sure, there are a few that became physicians to improve social standing, meet someone’s expectations or perhaps lack the imagination to do anything else. I’ve met those physicians…my favorite saying is that someone had to graduate at the bottom of the class. I’ve met some that are quite compassionate and others whose bedside manner could freeze, well, you get the idea. I’ve met some who want to educate me, lay out my options. And I’ve met some that need educating. It is a mixed bag with respect to doctor-patient relationships.

But, I have found there is one thing that doctors as a group don’t handle very well. Mental illness. Just mention that you’ve got the blues and out comes the prescription pad. Try to convey how mental illness affects your daily living and you will most likely be met with many nods of the head, but no understanding. It’s an illness that has no cure, piggy-backs on other illnesses and is so stigmatized that people go to great lengths to hide any signs that might even be remotely interpreted as mental illness.

It’s time to break that stigma. It’s time to stop over and under reacting to the human condition. It’s time to realize that mental illness does not define a person. It is an illness. It isn’t simple to “fix.” It’s frustrating for everyone, especially the person going through a crisis. We need doctors to understand that in order to grasp what is ailing a person, they shouldn’t balk at our mental states because they are messy. We are people. By nature we are messy.

But doctors degrade me. As soon as my past comes up, it becomes the driving factor behind my medical treatments. They start talking to me like a toddler who needs stern guidance. They threaten to take away my decision-making rights under the guise of keeping me safe. Medical care is withheld “for my own good.” One whiff of mental illness and suddenly I’m no longer a person. Doctors act like I’m contagious and try to lock me away, to shoo me out of their office as soon as possible so they don’t “catch” it.

I am honest with my healthcare providers about my past. I want them to understand that this is part of me that I have to live with every single day. I need them to understand why some things that they suggest are not realistic for me. In response, I get labeled as “non-compliant,” “faking it” and “attention seeking” to name a few. I have those in writing from physicians I’ve just been treated by. They met me twice and decided that, despite reams of quantitative data and hours of testing, I’m “faking it.”

Maybe I should stop wearing my happy face all the time. Except then I’d be labelled with something else and probably placed in a mental health facility. This burning need (and of course, legal liability) to control my behaviors because of my mental illness is ridiculous. Ten years ago, I was in therapy. I was having a bad day and said it would be great to just go to sleep and never wake up. That resulted in police knocking on my door, performing a “welfare check” which I’m sure, had my husband not intervened, would have resulted in me being removed from my home and institutionalized.

So why do my doctors become so concerned about my mental health to the exclusion of my physical health? Is the driving need to preserve my life by any means possible only applicable when they think I might hurt myself? Do they ever consider that their actions, their fervent desire to prevent any behavior outside of “normal,” may be the reason people act abnormally? When I ask my doctors these questions, they stare at their shoes. I guess it’s easier to blame mental illness than it is to try to find answers.

We should not fear physicians. They have knowledge, but we give them far too much power. They make mistakes and based on anecdotal observation, may panic around people like me because they see themselves when they look at us. No one likes a reminder of frailty staring at them.

To those who live each day with mental illness, know that there are many others standing with you. Understand that even if others don’t admit it, statistically 3 out of every 5 people in he United States is affected by mental illness. No one can fully understand the effects of mental illness. I would tell you not to be afraid of doctors, but I can’t in good conscience state that. Until people stop placing a stigma on mental illness, we will always be at risk of being marginalized, degraded and ignored.

Today, just accept that we are all human. Help someone understand that mental status does not define a human being, Embrace your friends and family, warts and all. Support the people you know are struggling and always be kind because you don’t know what state of mind someone else may be in.

7 thoughts on “State of Mind

  1. I can completely relate. I could write so much about it and how it has affected my depression and anxiety issues. It’s been 10.5 years now that I’ve diagnosed with MS and that really is the catch all for everything. Very frustrating. I’m glad you’re speaking out!

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  4. There’s a lot here that I need to reflect on further. As a psychotherapist I face mental illness all the time, in my personal and professional lives. I have struggled with MI myself, my family members have too. I’m not sure whether it’s because I’m a psychotherapist that people don’t seem scared to tell me about their MI, or whether that’s why I’m a psychotherapist. I know that some treatment providers (e.g., some doctors, but perhaps most?) just freak out when MI is discussed. I need to think about your words here because it has been my standard practice when beginning to work with a new client struggling with symptoms of MI to ask clients to go to their doctors to rule-out or identify/address any medical factors that may underlie or exacerbate their symptoms. I send a letter with them asking for some specific labs including vitamin levels, thyroid, and other things. I need doctors to be my ally in treatment, and I’ve never had a doctor refuse to do the tests. (Many times, the labs come back and reveal a problem that would likely have never been diagnosed if I hadn’t asked for the test, and to doctors are always surprised). But your post reminds me that just because they do the tests doesn’t mean they continue to treat my client/their patient with the respect and regard they did before. Perhaps I need to start talking with my clients about these risks before I send them to their doctors… Maybe I should suggest that if their doctors start treating them differently (in a bad way) that they should change doctors… It’s hard to know how to proceed. Thanks for sharing this post.

    • I can see ruling out underlying conditions as many things such as hypothyroid can mimic or even “cause” the symptoms of depression. In the short term, I have had colloboration between mental health professionals and other members of my health care team. As time passes, my teams have stopped colloboarting and turned to almost exclusively relying on the “other half” to take care of my needs. In my experience, things that occurred during the acute onset of MI are the most destructive and therefore the most memorable. Even with my medical issues, I don’t have doctors write small details in their notes, just the “big” details. The end result is that MI comes up front and center in all discussions (much like if I’d had a heart attck or other serious medical issue). Because of the ease of blaming things on MI, it becomes a catch-all and, quite frankily, an excuse for medical professionals to not look deeper into illness.

  5. Wow! I can absolutely relate to that. What’s also frustrating, is when a physician doesn’t know what the physical problem is, so they just say it is a psychological issue and that the symptoms aren’t real. There is a lot of stigma with epilepsy as well, and many medical professionals link it to mental illness, which is further stigmatized. It’s really sad and frustrating that so many of us have to go through that, and suffer further pain and discomfort.

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