Fighting the Stigma

I am leaving on vacation for a much needed rest tomorrow and will probably not be writing anything during that week so you will likely not hear from me. It has been a year since I have had a proper vacation and even the most dedicated professionals need a break now and then. I have reached the point where the staff have felt the need to reactivate the once dormant "F-bomb jar" because my language has been getting a little rough. I will discuss the jar in a later post. A few parting things before I go.

People do not choose to be depressed. They develop this condition over a time of prolonged stress. To pressure them to "just get over it" is one of the worst things one could ever tell a depressed person.

Prozac does not cure a person's problems. It just gives him the strength to go out and solve them himself.

Thorazine was far from the perfect medicine, but it was a start. It gave a lot of people hope where there was no hope before.

Most of the time the difference between the patient with bipolar disorder who is wildly successful and the one who is homeless and talking to a dumpster is compliance with treatment.

Every time a patient goes off his medication because he does not like the stigma of having a mental illness, he ultimately ends up decompensating, acting out of control in public, and being committed to the hospital. This only reinforces the negative stigma of mental illness.

Every time a patient remains compliant with treatment and goes back to her life, is successful and lives a happy and productive life helps to fight the negative stigma on mental illness. People like Jane Pauley, Fran Tarkenton, Mike Wallace and Kay Jameson, PhD have all come forward and discussed their struggles with mental illness and despite those struggles, continue to be productive citizens. If only more of my patients would follow their lead, the stigma would continue to lessen and the burden of mental illness become less overpowering.

Case in point. I will always be haunted by the memory of a man who when on his medication was very functional, personable and had lot going for him. The problem was he would never accept his diagnosis of bipolar disorder and would always stop his medication even though he was working, had friends, a stable life, etc. Ultimately he would lose it all and have to start all over again. This was usually after a tumultous hospitalization. One day we received word that his girlfriend had stopped by his apartment to see him, and found him hanging from a light fixture. This did not have to happen. I identified with him a lot. He was very close to me in age and I have a lot of life left to live, and so did he.

Despite the losses, if I had to do it all again, I would still choose to go into psychiatry. Even if I will never make enough money to afford a Ferrari like the heme-onc docs do. At least I can dream of that Audi R8 some day.