Dr. Action Potential has made no secret of her battles with anxiety and depression, and the fact that she takes Lexapro.
Does this bother me? THAT A DOCTOR IS ON A MEDICATION FOR A MENTAL CONDITION?
Absolutely not. I commend her for speaking out on it. Personally, if my doctor has a problem, I'd want them to be getting care for it.
Why do psychiatric disorders get "blacklisted" as a human condition? Insurance companies don't want to pay for them. Employers don't want to give time off for them. Relatives often don't believe in them ("Oh, she just needs to get over it. She's fine.").
The lady who has a heart attack and requires coronary artery bypass surgery gets time off from work, medications and doctors covered by her insurance, and cardiac rehab to help her recover. But the guy who has severe, nearly suicidal, depression? He may get a few days off work by calling in sick ("I have a cold.") He likely won't find help from a psychiatrist because his insurance doesn't cover them, and if he can't afford to pay cash he's SOL. If his boss learns what's really wrong with him he'll probably get fired.
His internist will try to help with some Cymbalta or Wellbutrin, but doesn't have the knowledge on what to do if those fail. Nor does she have the time to spend with him at his appointments because, as a primary doc, she's got a packed schedule.
So let's go back to your doctor being on Lexapro (or whatever) for their mental health. Does this bother you? Why? If your doctor was a diabetic wouldn't you hope they're taking their insulin like they're supposed to? Or blood pressure medication? A doctor who takes care of their own health issues is (hopefully) going to be around longer and capable of practicing better than one with out-of-control blood sugars or hypertension.
Yet, many people who learn their doctor was being treated for a psychiatric condition would probably run like hell from them. Why? If, like treating any other condition, it makes them better able to function, what's the problem? Wouldn't you want that?
Apparently not. Even though doctors battle the same demons as everyone else, AND are in a profession with one of the highest rates of depression and suicide, no one wants to hear that their physician may be on "crazy meds."
Insulin, Sotalol, Coumadin, Xarelto, Amiodarone, Herceptin, Tysabri, Cellcept, and many other potent meds for serious medical conditions - no one cares if their doc takes them. But Prozac? Hell, maybe you shouldn't be in practice.
So here's my confession: I'm on Zoloft (sertraline). I've taken it for 20 years. Don't like that? Think that means I suck as a doctor? I don't give a shit.
I've battled depression since I was a teenager (yes, for the doubting assholes out there, it's a real disease). I also have OCD. Not the personality type, but the actual disorder. Left unchecked, a circuit fires repeatedly in my head causing me to do pointless activities endlessly- checking light switches, counting to certain numbers repeatedly, walking in & out (and in & out) of a room. Those of you who don't face this have no fucking clue how awful it feels to know your repetitive actions are insane BUT YOU CAN'T STOP DOING THEM no matter how hard you try. Imagine being my wife dealing with that.
So, I take Zoloft. It's not a miracle drug for everyone, but in my case it works quite well. It keeps my wife from killing me for flipping the lights, or shower, or whatever, on & off too many times. It lets me focus on figuring out what's wrong with you, or playing basketball with my daughter. Got a problem with that? Go find another neurologist.
We might treat you for a mental illness, and wouldn't hold it against you, so why would you hold it against us? Or a lawyer, or decorator, or veterinarian, or politician (there's a lot you CAN hold against politicians, but this shouldn't be one of them), or plumber, or nurse, or accountant..., or anyone else for that matter?
I also take Lipitor for my cholesterol. Does that bother you? I doubt it. But I bet Zoloft would make you think twice about coming to see me. Why?
Your doctor, like me and Action Potential, is just another person, made up of the same organic chemical soup as you. We're going to have the same issues that you face (given the nature of this job, possibly more). And if we're willing to be treated for that, I personally think that's good. It let's us concentrate on taking care of you.
Which is, after all, why you came to us.
Your doctor can't help you unless they take care of themself first. No matter what their health problem is.
112 comments:
Thank you.
I wouldn't care if my GP took some sort of "brain drug" as I call them. Actually, I'd ask how they find it. Does it help? how are the side effects? How long did it take to find the "right" drug?
Well written!
So true!
Thank you so much for this post!
I go to the same medical school as Action Potential did, which has an esteemed psychiatric hospital right along a beautiful river.
I think that patients may perceive physicians as having an increased possibility of doing an inadequate job, or possibly putting in less effort, if the doctor is medicated, specifically, for something mental.
There is a false idea that the patient is here to get help [from a person who does not need help]. The second part should not matter in most cases.
We had a class discussion from a physician that battled substance abuse. I think that there is a legitimacy in being concerned about on-the-job substance abuse as it calls into question the ethics of the physician. Psychiatric illnesses do not call ethics into question- but people think that they do.
The "risks" in certain psychiatric disorders-which the public does not understand well enough- do not compromise medical care- but people think that they do.
If my physician has a disorder of the mind, the thinking goes, perhaps he wont connect to me as well as a patient. Perhaps he will make a mistake. By something, anything, being wrong, the false ideal of a physician as perfect (or at least "better than thou") is shattered for the patient. Some would rather live in a blissful ignorance where their doctor is perfect.
I think the the new crop of physicians is more accepting of mental disorders than before- I hope that time bears this out. It will be more acceptable for patients, too, once it is acceptable for physicians to be open to talking about it.
Thank you for speaking about this.
I would much rather have a doctor with a mental condition who was taking appropriate meds than a doctor who had a mental condition and *wasn't*!
Bravo.
As a pharmacist I see plenty of this mentality too, and do my best to explain the rationale behind antidepressant medications to the layman (with almost the same analogy oddly enough).
A diabetic needs insulin. Their body doesn't make enough so we give them medicine to make more of it. A person with depression also doesn't make enough of a different chemical, one that's produced in the brain. Their medicine makes more of it so they're healthy. Simple as that.
Kudos for sharing your experiences with the great anonymous masses of the internet.
Thanks for posting this. I'm a doctor in the UK and there are very few of my colleagues that I would feel able to tell about my (mild) depression; I worry that it would make them concerned about my competence, or hurt my chances of getting jobs.
Many respect to you Dr grumpy. I am a bigger more advocate fan of you now.
Thank you for your continuous inspiration. I was worried med school will push my youngest cousin to the edge -she has major depressive disorder since she was 13-
I now know she just need to take good care of herself. I can't thank you enough, I was trying to make her reconsider her choice.
I feel stupid, ignorant but saved.
Thank you.
A very brave post. It does not matter in the least what a doctor's ailments are, as long as s/he can treat their patients well.
I am based out of India, work in the pharma industry, and read your blog regularly. It is entertaining to witness the US healthcare system from a physicians eyes. Highly entertaining.
Considering your level of humor on the blog, I am delighted you have access to Sertraline.
Personally, I feel your patients have nothing to do with your own health - as long as they continue to lead better lives under your guidance.
PS - we Indian patients in India dont really check on the health of our physicians. Usually their degrees and diplomas along with recommendations are enough.
You wrote: "Got a problem with that? Go find another neurologist."
Good luck with that. Most neurologists have some degree of OCD, or they wouldn't be able to make it in neurology. And these days, many neurologists are fighting some degree of depression or anxiety. You're not alone, my friend.
A million thanks for writing this.
And, as long as my doctor is caring, compassionate, and focused on my health and well-being I don't give a shit what afflictions he/she may have.
Thank you for this. I'm a mental health therapist in a fairly conservative area, where it seems like half my clients only want benzos and the other half don't "believe in" mental health meds, and three quarters of them won't take their meds as prescribed so they don't work anyway. It's frustrating as hell. (Those numbers are not guaranteed for accuracy.)
I have a really delusional client who is convinced she did something terrible (she didn't) and she's been hospitalized twice this year for suicidal ideations, and I just had to send her to respite care recently (to try to avoid the hospital). Her mom made me so angry, saying (right in front of my client) things like "When will she just get over this? Why can't she just get it through her head that she didn't do this?" As if it is a bloody switch she or I can switch. We just haven't found the right med combo yet, and for certain things, therapy (or logic) alone just isn't enough.
I always emphasize that mental health *is* physical health - there are physical symptoms, and your brain (and your heart) are just as physical as the rest of you.
Amen, Grumpy.
Whoa, whoa, WHOA. First of all, I don't give a shit that you guys take antidepressants and other meds for your mental health. Not all of us judge, Grumpy. And second, I have NEVER been more stigmatized for my problems by a group of people than by my DOCTORS. Your colleagues are the most judgmental and unempathetic bunch of people who exist on this planet.
Sorry, but it's true. I now LIE about how I feel so that I don't get the eyerolls and judgment from my doctors, even though there are days when my physical condition is so debilitating that it makes my mental state very, very fragile. So fragile that a desire for death runs through my mind constantly.
Great and brave post - thank you!
Dr. Grumpy,
thank you for speaking up on this issue, which many of us healthcare professionals face.
Signed,
Old Squid, RN
The many people out there who look down on those who suffer from anxiety and depression would be HORRIFIED by the number of their seemingly "normal" friends, neighbors, coworkers, bosses, etc who are actually receiving mental health treatment. There are just so many of us (both in and outside of healthcare). What should be stigmatized is NOT getting help for what is a treatable condition for most people.
As a sufferer of PTSD (on Cymbalta), Trigeminal Neuralgia, Lupus and Fibromyalgia, I have tried and can't take many of the medications out there. I say if it helps, USE IT! It is why I am for legalizing medical marijuana. If it helps someone, use it. There are too many people out there that may need an antidepressant and don't take it. I do not subscribe to the theory that Doctors are gods. Like you said, doctors are people, too.
I've been to doctors that have given me the eye roll; because they can't believe I suffer from so much; but I've also had those who have moved heaven and earth to try and help me and failed. It's all part of the process. No one is perfect. No one knows it all. If you take Zoloft to help you, WTG!!! I can only imagine if a patient walked into your office and you didn't take it, let your true OCD come out, they'd probably run to the hills in fear. Anyway, we're all a little nuts and if people can't accept you, F* them! :D
As a nurse with anxiety and (currently) major depression, all I can say to this is THUNDEROUS APPLAUSE.
Thank you for your honesty Dr. Grumpy! - Mrs. H
Thank you Grumpy, for speaking out. Hubby left me when I was postpartum depressed because I was 'defective.' Some time later, new bf weirded out because I was on effexor. Thought it meant I was 'unstable' or something. I weaned myself off it, kept it to myself and raised 4 kids. Sometimes it is a daily struggle not to step out in front of a train. But the meds that help the depression carry such stigma, I just grit my teeth and keep it to myself. The Electronic Medical Record does not only increases my distrust of the system; my problems aren't just between me and my doctor, they're shared with thousands of creepy entities.
Doubtless this post will be linked by 90% of welfare recipients out there as "proof" of why they "can't" work.
This is enlightening. I wouldn't have thought twice about finding out my doctor was on antidepressants or being treated for any of those related illnesses.
I apparently live under a rock. Then again, I understand how brain chemistry can rule your life and I know how meds help, so...
STAY AWAY FROM ME! Just kidding... :D
I think the reason why people lack faith in doctors on psych meds in general is that they fear side effects ("What if he can't concentrate as well and fucks up my treatment...") or just don't want to burden them with their shit as well ("I need a doctor who's strong enough to deal with tough problems like mine...")
While that might even be true to some extent, what those patients don't realize is, there are a million reason why any doctor's jugdement or ability to handle stress could be "impaired" in some way (lack of sleep probably the most important one). And what a positive difference it makes if someone has the nuts (*hrhr*) to face their demons and work for their (doctor's, not demon's :D) well being.
So... Kudos to you, dear sir, for how you're apparently dealing with your demons and manage to be a decent human being! I wish, there were more people like you.
Doesn't bother me at all. Thanks for being honest. My drug of choice is Lexapro. I can't cry on it but it beats the hell out of the funk. I like getting out of bed and being a functional adult.
A-fucking-men.
Thank you, Dr. Grumpy, and all the best to you. My mom was diagnosed with depression after my father died, although I'm sure she was affected years, probably decades, before that. She took Celexa for the rest of her life. It let her be her true self--kind, funny, warm, playful.
--Queen Anne's Lace
I didn't read the comments because I don't want them to influence what I say. I hope that all of my oncologists are seeking help from somewhere. Their job is awful. My primary doctor told me that he is on meds and is in therapy. It makes me feel like he knows what I'm going through. He's not standing there thinking "just quit feeling sorry for yourself." I wish more doctors and nurses would step up and talk about it. Most of the time, all I have to do in an emergency situation is mention that I suffer from major depressive disorder and the medical staff quits listening to anything else that I have to say. In their eyes, I am no better than the drug seeker lying on an cot and yelling out in fake pain. I understand why you can't be open with it. Most people don't know what I know. They would judge you. There seems that there is no way to remove the stigma from mental illness.
You're on sertraline, too? It's only been a few months for me (mainly for anxiety, but also depression). Been on a couple of others, but this one works without making me drowsy. And I tell you, I wish I'd started it twenty years ago.
Husband's been on several different antidepressants, none of which work reliably for him. It's painful to see how he is some days.
15 years and counting on Zoloft. I ran out for awhile a few months ago and realized that without it, I'm a completely miserable asshole. THAT WAS ME for most of my life, until this miracle drug came along. I think it saved my life because if I hadn't done myself in someone else would have surely done it for me. By the way, FUCK YOU, Scientology and your puppet organization Citizens Commission on Human Rights. Quit spewing evil lies about mental illness and effective treatments.
Bravo Dr. Grumpy! I am a psychiatrist and I want to thank you for being forthcoming about your diagnoses and treatment. With every person who does so, the stigma lessens for everyone else. Love your blog, btw.
--Dr. Freudette
This struck a chord with lots of folks including myself, so here's my $0.02...
I saw a lot of this stuff in nursing school. I had bad anxiety to begin with but nursing school and other events in my life made it horrible and crippling. It exacerbated my depression that had been previously under control for years without meds. I was unafraid to talk to my doctor because it was either that, or drop out of school. I knew from past experience that if something didn't change, it would worsen to suicidal ideation.
I was a great student and other classmates looked up to me as someone who was super-smart and knew what he was doing and was prepared for anything. I didn't need or want that perception so I wasn't afraid to shatter it by explaining that I needed meds to keep my shit together. This was usually met with "I think I need something like that. What are you taking? Who do you see? How do I begin to talk about it?" No one judged me. We were supposed to treat people with compassion, so we did.
We nurses are all about getting you back up to your optimal level of functioning. We have no room in our profession to care about such trivialities as which chemicals you need from outside your brain to make the chemicals inside your brain behave. What we want to see is that you are at your best. When you are at your best, we don't really care what path it took to get you there. It's kind of like a state function. Then, you go back to work, or school, or whatever and do your thing because you're able again... just like those of us caring for you.
Thanks for talking about it Grumpy.
Thank you for being open about this. My current primary care doctor was so kind when I admitted needing help, explaining that it is not something you can just will or pray away; it is no different than someone with diabetes, etc. I think the stigma of being on meds for depression, etc. will only be lessened when doctors themselves are compassionate and people are no longer afraid to ask for help.
Aunt Murray...Amen to that..."I like getting out of bed and being a functional adult."
Choice 1: Take Effexor each morning. Go to work, go to gym, enjoy my family, enjoy my life.
Choice 2: Go off SSRI. Worry about stupid stuff even though I know it's stupid. Struggle at work because of worrying and feel physically uncomfortable. Develop physical anxiety symptoms (shortness of breath, stomach aches, and incessant leg shaking seem to be my body's favorites). Develop depression when anxiety persists longer than a week or so.
I went through Choice 2 several times in an attempt to get off the stigmatized drug. Now I say forget it. Why starve my body of what it needs.
My response to people who consider me weak for taking drugs to control my anxiety/depression:
I'm the mother in a very loving and functional family and I'm fully functional at my job. I take the medication to help me deal with a society where so many people are dysfunctional. If the dysfunctionals were taking meds like many should be, many of us now taking meds could probably go off them.
Commendable, Grumpy. I like knowing my doctors are human. I’m huge on mental health advocacy and ameliorating stigma. Everyone goes through shit in their life – everyone – and a little compassion and understanding goes a long way. These are the things that make us better people (and doctors) if we allow them to. That said, as a mental health professional who dated a med student who has had a couple psychotic breaks over the past couple years (allegedly while on meds), I would not feel comfortable having him as a physician for a variety of reasons mostly because he goes off the rails without warning and there’s the very real potential for a lot of harm before he’s really red-flagged. Hypersexual performing a pelvic exam during his OB-GYN clerkship (this happened)? Not OK. Extreme case but often times people with SMI do not have the insight (particularly while manic) to know there’s a problem and real harm can be done if they suffer from a psychotic form of mental illness – even if it’s intermittent – and if it’s not caught before seeing patients. I’m sure he’s great when he’s great but for those times he’s not? He’s a real liability – hate to say it. Loved him to the moon and back but would not want him as my physician, even though he’s brilliant, because those rare times his brain is completely and totally out of control and he’s unknowingly lost touch with reality and his colleagues just initially think he’s having a bad day? Nope. It’s not worth the risk to me.
An absolutely beautiful post, Dr. G. Old ICU nurse here; I've been on Trazadone for 20 years now.
Bless you for speaking out ~
Thanks for posting this. It was a much needed read for me this morning. My teenage daughter has been diagnosed with anxiety and depression. We tried lots of therapy and group sessions before making the decision to put her on meds. We're seeing the light at the end of the tunnel now. Thank goodness.
If my doctor needs meds of any kind, I want them to take it. Being a doctor doesn't make you invincible.
All Mental Illness is not the same as all Heart Disease. (Though Mental Illness can cause HD) The harsh truth many people do need to get over it, let go, and be reasonable, as they seek help for Mental Illness. At what threshold do we call it mental illness. We (licensed clinicians) are trained to diagnose. Severe Depression needs time off from work, and recognition of being shame free. Mild mood disorders, mild depression and anxiety are much, much more tolerated in the work place, hidden from other (certainly work related peers) and a much more complicated condition to define, as "treat me with the respect you have for Heart Disease." Such is the fallible nature of the human condition and the Art of psychology.
Bravo! Thank you for your bravery in disclosure. Many, many people will deal with a psychiatric condition at some point in their lives. We need to get beyond this idea that people are "crazy" and commend them for taking charge of their own mental health. I have benefited from developments in the mental health field; I wish more people would.
And you would be the first neurologist on my list after this admission, not the last.
Keep taking care of yourself so you can keep taking care of your family and your patients.
I applaud your decision to help yourself, and wonder is that why you chose neurology? If so, maybe some good came of your illnesses.
So, you must understand then how difficult it is to get chronic pain disorders - like fibromyalgia - accepted as a 'real' thing, then don't you?
Well, goody.
Now, add to that the shitty way a good many of us are treated every time we take a 'script to the pharmacy for a controlled.
Talk about adding insult to injury.
Judgers gonna judge, haters gonna hate, I say feck 'em all.
The Black Dog has visited me at times. The fear preceeding his visit was hard to describe. So , I found a tear forming in my eyes as I read your account. The thing that always works for me it to step up my level of physical activity, particularly riding a bicycle. Only later did I learn that there is a bona fide connection between exercise and relief. The usual treatment in my profession is administered on the rocks. Thanks for speaking out.
Don't know what I can add here, except to say that I wouldn't hesitate to hire a fishing guide who actually fished, so why hesitate to see an MD who is caring for him- or her-self?
But sometimes the irony of being told to lose weight from an overweight PCP is deafening.
Thank you for your honesty. Each time someone speaks up who has been successful it gives hope to others.
The stigmas permeate the mental health field. Stigmas against soldiers with PTSD as being violent, fakers, or coward, I see everyday.
My world is full of vets and current service members who fear those stigmas. And those stigmas take contributing members of society away, because it reduces treatment.
Let people with mental health needs get help and function. Do not judge them by the contents of their pill box, but by the content of their performance.
So glad you wrote this! So sad that if people can't understand something as standard, straight forward and needed as Zoloft for depression, how in the hell will they ever understand something like addiction say to the opiates you prescribe. Had dinner with two docs in this boat last night. Their careers are all but over because they had the misfortune of back issues (1) many ortho surgeries (2) and became addicted to their pain medication. People just don't seem to get it until they have to live it. Sad - but articles/posts like this can only help.
Thank you Dr. Grumpy. I have high blood pressure and depression, both controlled by medications, and I am fortunate that Paxil works so very well for me.
My son has OCD, and the SSRIs had too many side effects; my brother is dealing with near-suicidal depression and the very employment issues you discussed, the usual drugs not being effective for him.
Thanks to Dr. Grumpy for bringing up this sensitive topic that needs greater awareness in our culture.
Speaking as a pharmacist, however, in response to a point about filling prescriptions for nicely packaged chemical entities, in general and as well as specifically in regard to opiates for chronic pain (which is a slight divergence to the topic at hand), I, personally, would prefer to work with drugs that specifically fix problems to restoring 'health' and function. However, our technology has not reached that point, and the news is out that it will be some time that 'perfectly fitting' medications will be available. In the meantime, pharmacists often fill prescriptions that don't necessarily 'fit' their patients, and cause side-effects, including psychological dependency. Throw in abuse potential, and the pharmacist functional duty as the 'piller' of society is lobbed under 'keeper of the till' that is, both regulator of black market supplier of controlled substances as well as inappropriately filled prescriptions.
In many cases, heck, most cases, the patient realizes they have to 'put up' with side-effects or learn how to deal with them for the big ticket item of relief of symptoms and restoration of function.
I applaud Dr. Grumpy for forthrightness and compassion in defining the problem and its solution in order to fulfill his valued contribution to society.
I had a professor with OCD that refused to acknowledge and deal with it and often resulted in serious damage to his psyche. His strange off-putting habit of constant checking that he'd locked doors on leaving the pharmaceutics lab was only one symptom, and yet, had he come to terms, treated the underlying disorder, and moved on, he might have been a more enjoyable person and enjoyed life more, too.
Thank you. When will we realize (culturally, I mean; scientifically we are already on the way) that there is not actually a line between "physical" and "mental" illness? "Mental" really just described a physical illness we did not understand thanks to the complexity of the brain. There is still plenty to learn, of course, but why can't we see it as we see cancer, as an important problem we need to learn how to fix?
Thank you, Dr. Grumpy! I appreciate your strong stance on this.
http://www.robot-hugs.com/helpful-advice/
this says it all.
Haven't checked the other comments, but you're preaching to the choir here. I didn't even know this was an issue. I suppose having mental health issues myself influences my viewpoint, though.
One sentence bothers me, though:
If his boss learns what's really wrong with him he'll probably get fired.
Forgive my ignorance, but doesn't the Americans with Disabilities Act prevent them from doing that?
Thank you Dr. Grumpy. If you were my doctor, I'd be baking for you every chance I got!
Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you.
And thank you.
Now, if we could only get this to every employer (and human resource minion) who thinks "something wrong in brain = CRAZZZZY or a "liability", we would be getting somewhere. That if you seek help for a depression, you don't get fired (and more depressed).And so on. Your depiction of what happens with a GP or internist is spot-on.
Trust me, there are some bright, useful people out there sidelined because they are not "nermal," and don't write (another profession prone to the "not-normal.")
Thank you for standing up.
Oh, and I happen to know one of my docs takes something Rx'd for depression. I came across this info accidentally, and will never divulge (bring on the hot pokers, I dare you ) I am just in awe that this individual does so well, and yes, I have and do trust this MD with my life.
Dr. G, I already thought you must be an awesome person and MD, now I'm certain of it! Thank you for putting mental health maladies right where they belong, in the mainstream of care and tending, not to be hidden under a bush.
If a doctor is on medications (whatever they may be), I just hope they're prescribed by another doctor. I don't think it's good to treat yourself or your friends and family, because objectivity suffers when you're too close to the problem. But if you do have a medical condition, well gosh darn it, you're a human not a robot. Though if you really are a robot I know a great IT guy.
Dr. G, I already thought you must be an awesome person and MD, now I'm certain of it! Thank you for sharing and putting mental health maladies right where they belong, in the mainstream of care and tending, not to be hidden under a rock.
Yes! Yes! Yes! A million times YES!! I'm so sick of people not respecting mental health as a health issue. I have bipolar. Because my meds work, folks generally don't know. i had more folks at work concerned about my mental state when I spoke out about having bipolar than when I had a broken toe (yes, I'm a dork!) when it was in a boot.
Kuddos to you Doc Grumpy! I think it is great that you are comfortable telling everyone that you are on meds. Maybe more docs will speak up and take a stance and show the world that everyone can suffer from some sort of mental illness and it is not shameful to get help.
I don't get the stigma. No one tells people that are visually impaired that blurry vision is all in their head. That if they would just stop being lazy and squint harder, they wouldn't have problems. Why is mental illness any different?
As for the pharmacist commenting about "imperfect" drugs not being a good fit for everyone, I have to wonder how the pharmacist is somehow more qualified to judge whether or not medications are a good fit for people, seeing as I interact with my pharmacist probably 5 minutes a year. How is this somehow better than the 30 to 45 minutes my physician has spoken to me about this medication with full knowledge of me and my patient history? Unless my medication will cause me to spontaneously combust within 15 minutes of ingesting it, please refrain from making judgements about me, my life, or my doctor. It's called professionalism.
Bravo, Dr. Grumpy!
I once had a psychiatrist who admitted to taking anti-depressants. Didn't bother me at all. In fact, I liked that he could empathize with what I was going through.
Then I started noticing that his moods were nowhere near stable, and he was often angry and lashed out at his patients. Apparently his meds weren't nearly as effective as he'd told me. I got out of there like the proverbial bat out of hell.
I have no problem at all seeing a doc who has a mental illness that is being properly managed.
I am a physician on a powerful"Brain Medication" Tysabri for aggressive MS which I have. I still practice with a patient population with a high degree of psychiatric co-morbidity. My patients have been wonderful and accepting of my difficulties which in turn have allowed me to more fully appreciate the "mind-body connection" and the extreme importance of treating and learning how to live one's best life with psychiatric difficulties. It is guaranteed that if you don't take care of the mind the rest of the body will not do well.
I would rather have the man who tends my herd of Mongolian yaks to manage his condition with Zoloft rather than with ethanol.
I've spent decades playing "you bet your life" trying to overcome lifelong health problems as a systems analyst consultant in group healthcare. A doctor that is willing to use the same drugs for the same reasons for themselves and family speaks of a certain honesty to me as well as actual experience by having their own skin in the game. I learned how to cure myself of FMS, CFS and congestive heart failure. Because of my experiences I asked questions researchers never think to ask, and as they turned out to be correct questions, I recovered. I started with something that helped some people and debugged the therapy and eliminated more than a dozen reasons for it not to work. Now there is a predictable response pattern. A doctor can't study anybody else in the depth that they can experience and study their own body.
I just started Zoloft myself just to manage anxiety (as a department manager, I realized it wasn't healthy to hate and want to kill all of your employees). So far, nice improvement. I felt like a little bit of a failure having to ask for chemical help but I sure am glad that I did. My husband is THRILLED! :-)
Pharmacist here responding to accusation we are 'judging' patients; am sorry for the broad situation across the field of healthcare which sometimes fosters this impression.
However, it is beneficial to society to as a whole to devote research for understanding how the functioning of the brain and central nervous system affects physical, psychological, and mental health.
Thank you.... It is always, always good to be reminded that my invisible illnesses affect other people.
You're the best, Doc Grumpy. Please give yourself a long hug for me.
I just retired as a solo FP for 46 years. I suffered dysthymia from teens ... found that nicotine gave some element of relief ... smoked cigarettes for 34 years ... quit after an 8 year struggle on 2/20/1986 @ 10:02PM !!
Never tried any other drugs ...really ! Served as physician in Navy and returned to become an FP ... recertified 5 times and finally with Obamacare had my vocation stolen. In 1990, with much trepidation, I started myself on an SSRI ... the relief I experienced can only be described by another who has travelled the same route. Have been on an SSRI ... currently Lexapro/Wellbutrin for 24 great years !!
My 5th and 6th sons with my 2nd wife ... inherited my disorder. One went thru Princeton/NYU Law and is a successful att'y in Philadelphia. The second is in his last year at Harvard in economics. My 1st wife died (schizophrenia, etc) and my 2nd wife raised the 4 children I brought along ... none of them was afflicted except for some anxiety.
Because of my condition, I had the largest non-psychiatrist psych practice around and became really proficient at treating. YET, unless you enter each and every room with the dictum that you must prove that the person before you is depressed, you will fail to diagnose them miserably !!!!!!
Big hugs and thanks to you, Dr. Grumpy! I think everything I want to say has already been said, but I agree that you would definitely be my number one choice if I had to switch to a new neurologist.
I have struggled with depression and anxiety and I know the stigma attached all too well. I also have migraines, and I believe there is evidence that migraines and mental health issues can be and are co-morbidities. My neurologist has said it's true and treats me accordingly. If only other heath care professionals were as informed and compassionate... sigh...
Thank you for being so very honest, and please continue to care for yourself first!
Dr. Grumpy, I think you and your family rock! I do believe that there is a LOT of ignorance out there and that's why there is still a stigma out there regarding "happy pills". My family doc is on anti-depressants. He's facing his demons head on as he says, and I'm proud to know him. He's an amazing guy and excellent doctor. I have to have my Zoloft for anxiety. My chemicals are all fuckered up and I know it; I'd make the first page of a newspaper if I didn't. I'm sure my husband is grateful. Keep up the good work Dr. G. You're an amazing man!
Thank you, thank you and thank you again for addressing this issue. I've had people tell me to get a life, get over it or stop dwelling on sad things. I've been on series of antidepressents for 20 years. I tell people that they'd take vitamins if they were anemic and that antidepressents take care of a chemical that the body is missing.
Been following these comments all day and something I've suspected for a long time now seems very clear...
Either Dr Grumpy is a magnet for people with a wide range of mental health issues, or...
There are a way more people in the mental health boat than any individual realized. We need to open the floodgates and start feeling like this is as acceptable as diabetes and high blood pressure.
Maybe Dr Grumpy can be our spokesperson... Cuz if it's good enough for Grumpy, it's gotta be ok.
Well said.
It wouldn't bother me at all as I have taken Zoloft for ~10 years and know it doesn't affect my decision making. It takes the edge off depression so I can cope with life. My family and closest friends know and some of them are on the same treatment for the same problem. No big deal. If you had said pot, meth, coke, heroin, I probably would feel differently.
Freddd, if you have a cure for heart failure please share if you don't mind. My doctors tell me it is always incurable and I would rather fix my heart failure if that's possible. Thanks
You are absolutely right, no one should be judged for taking medication for mental health reasons. As a matter of fact, they should be commended for taking medication, as well as for taking care of themselves.
There was a time where I can remember people in the medical field who had the attitude of, "Do as I say, not as I do" instead of, "Practice what you preach". I remember doctors who smoked, yet advised their patients against it, and doctors who were obese, yet yelled at their patients, who were not nearly as large as he/she, to lose weight. I prefer a doctor who will practice what he preaches. It means he or she cares about themselves and about health overall.
As a sufferer of OCD, GAD, Panic disorder, and social anxiety, I know what it's like to be stigmatized for mental health issues. And the worst part is that I'm not med compliant, which means I've had to overcome my issues the hard way, and I still have a lot more to work through. I find it odd that people find it acceptable for others to go to therapy/counseling, but if someone takes meds for a mental health disorder, people judge them harshly. Even a church I attended told me I was sinning by taking Xanax. (I quit attending that church after that.)
Again, you are absolutely right. Many people see doctors who take medication for high blood pressure, diabetes, etc, so how is that different from seeing a doctor who takes medication to control his Bipolar Disorder?
The illnesses and issues your doctor may have, or the medications they take, those things have nothing to do with whether or not he or she is a good doctor.
Frankly, I prefer to be treated by a doctor who has suffered from illness and understands from the gut what it's like not to be healthy. In my experience it enhances their compassion.
The first doctor I ever saw for depression told me if I were a better Christian I wouldn't be depressed. Since then I've spent about 30 years in therapy and (concurrently) 17 years on various antidepressants. Both work; in my case (complex PTSD, major depression, ADHD) both are necessary. The meds and the therapy help me to function in work, relationships, and society.
It would be a dreadful waste to prevent people with treatable mental health issues from using their intelligence, insight, and energy -- as doctors or whatever else.
Why do we stigmatize mental health problems as something we should "be able to handle without medication", yet no one cares if you take blood pressure or cholesterol medicine. Let me tell you...I can manage cholesterol and blood pressure through a healthy diet and exercise. I can't change my serotonin levels by eating less junk food.
Been on prozac for 20 years. Keeps me from biting off heads. Love you for saying this. you rock!
Wow....
I don't have problems with a doctor doing what he has to do to keep stabile and healthy, but a cruise liner size group of your esteemed colleagues sure do. What a bunch of judgemental asshats.
So I keep my mental health problems so far in the closet the hat boxes fall on me. I pay my shrink cash, so it keeps out of the EMR. I'm not on any medications that ping the nut-dar of my other doctors.
I'd rather die than let anyone know I have a mood disorder. Society treats us like utter dog shit, and the medical profession isn't any better.
So rock on Dr. Grumpy! Fight the good fight for us who are too beaten down and marginalized to make a peep.
And a big SCREW YOU to my former nephrologist, who made a face at my psych diagnosis, and told me, "I hate treating the mentally ill. I have a hard time believing anything they say."
SkullCandy313
I wish I could write what this admission means to me, and how I relate, but I can't yet. I just can't.
Until I can, though,
thank you, dr. grumpy.
Thank you! Thank you so much for speaking out about this.
I'm sorry to hear you suffer from the same thing I do - but glad you found a medication that worked for you.
I'm glad you find help with Zoloft. Before the invention of SSRI's my first husband started exhibiting symptoms of bi-polar illness after his first year of med school in Houston. (At first he was just depressed/suicidal, the manic didn't start until after his second year.) Did he stay on his lithium?...sadly no. He ultimately shot himself in the mouth out at his mother's ranch north-west of Houston.
You are awesome, Doc G.
As someone who has suffered from long-term, ongoing depression, including the lovable (sarcasm) anger angle, I understand that getting medicated is the better choice. I'm currently on sertraline myself, and my brain simply does not work properly without it. (The sad part is the current fairly high dose I am is stifling my ability to write; I'll have to discuss that with my doctor.)
I regard a doctor who is getting medical treatment for mental issues no different from my medical-oriented relatives getting treatment for physical issues. (Dad's older brother is a GP, his wife's an ICU nurse, and stepmom's a retired pediatric nurse.) It's just something that needs to be dealt with in order to live instead of exist.
The odd part is that, while my father is currently willing to acknowledge that my issues are biological and can't just be wished away, he's currently refusing to extend the same courtesy to my son, who has been showing signs of depression and is in his first month of counseling. (For non-emergency or cases that aren't blatantly obvious, there is a mandatory time period of evaluation and counseling required before medication can begin. Keeps down the drug seekers and parents trying to zombify their children into behaving.)
I detest religious types who say you're 'sinning' by taking medication to fix farked up genetics or brain structure. The only thing the Bible says about it is not to abuse things like alcohol; even Paul recommended to Timothy to use a little wine for his sour stomach, for pete's sake. I see it as we've been given the ability to figure out (slowly) what's wrong, and find and make medications to sort things out. To help ourselves. Some people need to read instead of parrot.
Here's a fun fact to leave you with: Serotonin, the chemical in the brain that a lot of anti-depressants work with to help sort things out, also helps regulate digestion. So that constant sour or upset stomach may literally be associated with the patient's mental issues.
Excellently written post.
Thank you
Well spoken!!
Kudos Grumpy, for having the courage to out yourself.
I have no problems with doctors taking medication for mental illness... as long as they are seeing an appropriate medical professional themselves, and their condition is being managed effectively.
We don't let people drive with uncontrolled seizure disorders or uncorrected visual impairment. We shouldn't let people with serious and uncontrolled symptoms of mental illness treat patients.
If my doctor were nearly catatonic with depression, I wouldn't trust them to treat me effectively. If they were functioning well on SSRIs, I wouldn't have any problem with them being on medication.
I'm on SSRIs for serious depression myself, and they have transformed my life too.
Dear Dr Grumpy,
Thank you for this fabulous post. I've never understood the stigma associated with mental illness, given that the brain is just another organ (albeit an exceedingly complex and not completely understood one). Perhaps we should all lobby the AMA and insurance companies to require that a basic mental health screening be a required part of every physical exam. If every patient is screened, eventually people will get used to it and not be so afraid. I also think mental health should be a required part of school health education...right now it seems to be relegated to something one discusses with a counselor at school only if there's a problem.
Thank you again for a beautiful post.
Bravo! Well said! Much respect and admiration for you Dr. Grumpy!
I worked for decades while taking meds for depression as a PC Tech and worked my way up to a Sr Programmer/Analyst all the while on Prozac and eventually Wellbutrin too with a short time (When my dad and best friend died on the same calendar day within a few years of each other and within 2 days of my mom's date of death) where I needed a nerve pill as well. Ya know what took me out of the work pool? Pain from a bulging disk in my lower back!
Dr Grumpy. I'm going to repeat a lot of what's been said but...
Thank you.
My primary care physician was in a car accident, one that killed his son, and dealt him a fair bit of head trauma. The minute he was well enough to practice again I returned to him.
I have a friend who needs to visit neurologists, and she has stated in the past that she'd love it if hers was like you. After a post like that? She'd be even more firmly in that camp.
More importantly... Thank you. I suffer, and my meds don't work as well as I'd like. I'm not really functional. But they keep me out of the hospital for the most part.
The stigma is soul crushing, and just... thank you. You've widened my world a bit today.
Thanks, Doc. If I needed a neurologist I'd come to you just because of this post.
Thank you for brining up this topic, which I have found is definitely not talked about enough. Also, thank you for being open about yourself. I am a Physician Assistant who specializes in neurology and have been on a variety of anti-depressants/psych meds since high school. I recently tried going off one of them (after discussing this with my doctor) and my anxiety increased to the point where I was having daily panic attacks, having times each day where I was in my office trying to figure out how I would make it through the rest of the day. Since going back on the medication I'm back to normal - just trying to catch up on all the charting I got behind on during that 3-4 week period! So, if patients want me to be able to best serve them, to be able to focus on their issues and really help them - I'm going to be on psych meds. But, would I ever let any of my co-workers or patients know what I take. Heck no! Because there is still that stigma and I bet I would have a lot less patients then I have now.
The stigma of mental illness endures. I have bipolar disorder, or that is the simplest way for explain that I have severe depression and anxiety symptoms that are enduring and persist despite treatment. I am on a bucketful of meds, antidepressants, mood stabilizers, anti-psychotics. I have been hospitalized twice, once involuntary.
I have always struggled, but at one point I could not function. I headed the finance department of a non-profit, lots of responsibility. I had a breakdown of sorts. My employer sited the fine print in the ADA.... and I was fired.
I went back to school to get my MSW. Even though social workers are all about social justice and wellness...they were the worse department at my huge university in regards to accepting accommodations.
Anyways, I have a social work license and have the credentials and have worked as a mental health counselor. I reveled to my coworker that I was bipolar and I was fired for some BS reason shortly after.
I have since worked in the "peer movement." I worked for a peer run agency as a peer advocate. I have the credentials to actually diagnosis and treat a mental illness (LMSW), the non-peer staff that worked as case managers did not. So even though I had advance degree and license, the other less qualified employees in other departments treated me like crap. It was maddening. So in the mental health field, there is incredible stigma to being a provider with a diagnosis.
I work in a peer run agency (not just a peer run program). Now I get shit for being a traditional mental health provider.
It is like damned if you do, damned if you don't.
So... there seems to be less stigma with depression and anxiety... Bipolar? Schizophrenia? Not so much...
Oh and there is a shortage of psychiatrists so we have to endure really bad care.
Thanks for coming out... It helps us all!
Thank you very much for this post. I am a pharmacy student, yet am surrounded by coworkers and classmates who have expressed judgment and disdain over my taking anti-depressants. It is so frustrating that I am judged for taking measures to become a functional human being--something I was not before taking medication. Thank you.
I've been reading for years but this is my first time commenting on your blog, Doc.
I can't tell you how many times I've been told to "get over it" when it comes to my depression and it enrages me beyond belief.
I work in the operating room and the stress of the job is bad enough without my ongoing depression. Without therapy I would never fully understand what my triggers are and how to avoid them. Without my medication, I wouldn't be able to focus on the task at hand and do my job— which I love very much. I tend to keep my depression a secret. I find that even within the medical field people are judgmental and I'd be heartbroken if I was pulled from the surgical team I work with because someone thinks it's "too much for you to handle," as my mother so often says.
Thank you for this post and your honesty.
Before I retired, I was a professional photographer. I have diabetes. I didn't want to inject myself in the banquet hall, so I would go into the bathroom to do it. More than once the bride was told that I was in the bathroom doing drugs. I ended up getting an insulin pump because I didn't want the bride thinking she hired an addict.
Great post, Grumpy!
I think people need to realize that doctors (and nurses and other healthcare professionals) are also human beings and treat them accordingly as individuals.
You are not OCD, you are a doctor, husband, father, son, etc.
You shouldn't have to spend your life as a diagnosis of whatever.
The older I get, the less I tell people I work with. I hate the armchair quarterbacking and very little empathy or concern.
Sometimes I think I live in a bubble.
I find people who have had to struggle with something like this more interesting. I find people who have struggled and overcome to be better people for it. Plain and simple, these are people with insight and courage.
Then again, my husband is 5'6" and when we were dating, he used to tell me that women wouldn't give me a second look simply because of his height. He's brilliant and kind and I couldn't fathom that. Turns out women don't take to short guys either...it's amazing!
I will never understand the need for people to want either people who look and think like them or worse...perfect people that don't exist except in their own minds.
It was a great post and I hope that it opens some people's eyes to the fact that we are ALL different. When you judge others, you open yourself up to their judgement. When you accept people and for who they are, you open yourself up to the most amazing diversity of life and experience there is...truly amazing.
The same stigma exists for bus drivers. Yes there are certain drugs that we should not take if we are going to be driving kids, but my biggest fear was that the people who do our physicals were going to take me out of work because I occasionally have to take Lorazepam (Ativan) on top of my Doxepin (Sinequan) to manage my anxiety and depression. (As a side note, it started out as only Lorazepam but then I found I was allergic to SSRI's (Paxil) and thus a search for the proper anti-anxiety/depressant began.) As such, if I have to take a dose of the Lorazepam to break an anxiety cycle, I consciously choose to call out of work the next day or take it early enough (4:30 to 5 pm) after my normal afternoon route so that the medication has time to work and make its way out of my system within a reasonable time frame. Just because I have anxiety and depression doesn't mean that I can't actively hold a job. Oh and I know of a few doctors and nurses on anti-depressants/anti-anxiety medications, and would trust them to save my life!
A doctor seeing another doctor to get meds and take care of a mental illness is a SMART doctor!
My son, a senior in college, has recently been diagnosed with bipolar and anxiety attacks, and while the college is bending over backwards to accommodate him, I hope he can get stable enough on meds this year to function as the Real World I know will not be nearly as accommodating.
The brain, like any other organ, can get sick and need meds. There should not be a stigma. Folks who don't understand that, and think it is "all in your head" etc. should just hush up and thank their lucky stars they do not have a mental illness (unless lack of empathy is a mental illness haha)
JFS in IL
Great post! I call them happy pills too, they help a lot. I still have issues living in the northeast during November through March. My dad is always a great one to use the get over mentality and I think he needs happy pills too. I think he has always been is a major depressive state my whole life. Besides the depression, I also suffer from migraines, which only those that get them understand. For the last 5 weeks, vestibular issues have been added. I actually had a friend tell my husband I was full of BS with the dizziness. It's awful that the "hidden" illness do have their disbelievers! Good luck to everyone on happy pills!
Been there done that too Grumpy! Was on Wellbutrin for a couple of years when it became obvious that I needed to treat my depression or kill myself..and when the voices telling me that it would be easier to die than live, I got help. Love ya man!!
Bravo. Zoloft and Prozac and Klonopin here, occasionally a Xanax for panic attacks, and anybody who thinks that it's a weakness gets bitch-slapped! :D
Amen and Amen! I am in academia, as well as practicing and I am open with my depression and need for Paxil (for 20 years) with my students and residents. Going through this has made me better able to notice when a student, resident or patient is struggling with depressive symptoms. I let them know it's ok, it's not something you can fix yourself and getting help is not a sign of weakness. Many of us in health care are Type A perfectionists and feel that we have to be able to handle anything. I can speak from experience that we can't. Thank you for being open and honest.
As an happily employed PA with anxiety and depression and 8 years of sobriety strengthened by ssri I thank you for this post. I haven't even thought to be ashamed of prescribed ssri use ha ha!
I think that you are a yak herder both brave and wise, and I am glad that you are a gifted writer as well! I'm approaching 60, on meds since mid 20s, and wouldn't be alive if it weren't for that! Strong family hx of substance abuse and depression, and incestuous family of origin = chronic depression/PTSD sx even with good psychotherapy for as long as I have been on meds. I've been blessed with good insurance (hubby works in a good industry and live in state with true MH parity for over a decade). Have managed to stay employed (part time, but steadily), stay married, raise a child who is a well functioning adult, etc. The stigma is dreadful, and truly does kill people! Thanks for your honestly. I wish every MD and PA and NP who does not 'get it' about mental health issues could read this post and the comments. I don't share my info very often, as it is used against me more than it helps....
I've had depression on and off but I always thought it was strictly 'environmental'. I had an unhappy childhood and ongoing troubles in my career, my self-esteem. I couldn't tell if I really needed treatment. My mother has been on Seroxat / paroxetine all my life and warned me off trying medication. For her it just seemed to add to her problems.
I was so scared to try taking pills. I was so scared asking for them at the doctor's. I was scared it would be like a chemical lobotomy for my brain. Change me somehow.
I've been on sertraline for a few weeks now. So far, I think it's wonderful. I've found I'm still me. I'm just me without a mental illness weighing me down.
I am a pharmacist with OCD and wouldn't wish it in my worst enemy. No, not the "haha, must be my OCD coming out" kind of disease. Left unchecked, I can get stuck in pattern that lasts for hours. Hardly funny.
Thank you for your honesty. Too many healthcare professionals hide behind their degrees...
Thank you for your post. A month ago I started taking sertraline, at great distress to my mother, who is afraid of it for the black box warning and whatnot.
It makes me feel better to know that you, a competent working doctor, can take it and cope. I'm an EMS provider and I'm going to law school. But it makes things very difficult to continue when I'm depressed to the point of wanting to kill myself. The sertraline helps.
Blah blah blah. Just saying thank you. It makes me feel better to know that there's a functioning and wonderful person like you on the same medication.
Great post, Dr. G... working in a clinic where many of our docs and nurses fill their own prescriptions, I am acutely aware of how 'human' they are. I pass no judgment on anyone for needing sleep aids, antidepressants or anti-anxiety meds. Considering the stresses of the job, I'm surprised there aren't more. Patients can be completely oblivious to the fact that we are human too. I feel much better about seeing a doctor who can empathize with me, without a doubt.
Wadda I think?
I think it's a gutsy post and will be appreciated by a lot of people.
Jeez, imagine, a doctor admitting that doctors are human and can benefit from appropriate treatment for their medical problems.
Now who do I want treating me, Dr. Grumpy or some guy desperately clinging to his pedestal?
Add another thank-you to the pile. Your post actually was the catalyst for me getting off my butt and talking to my doctor. I've only taken 3 doses of sertraline so far so it's too soon to know if it works, but I'm hoping to become a less short-tempered/discouraged/fearful version of myself soon. My husband grabbed me and kissed me repeatedly when I told him, so apparently it was past time for me to take this step!
MLS in CO
Pharmacist here.
I took Wellbutrin for about 11 years. It probably kept me alive at least once.
I've been off it for nearly two years so far, but I always keep a sealed bottle in the house, just in case I need to go back on it in a hurry. Kind of a "break glass in emergency" thing.
I don't see it as any different from the drug(s) I take to keep my tachycardia/frequent PVCs under control. So one works on my heart, the other on my brain. Why should anyone care?
And yes, I've filled sertaline and Ambien for one of the local doctors, who is very well-respected by the entire community (although I assume they don't know about this, and obviously I'm not saying anything). I didn't, and don't, think anything less of him for taking them.
Thank you for sharing this! I've always wanted to go into medicine, but have also struggled with mental health since a teenager. When things were at their worst and my psychaitrist recommended filing for disability, I was afraid to. One reason was having records about being "crazy" and afraid maybe I wouldn't be able to practice medicine in the future. I'm still a long way off from practicing due to the years of mental health issues, and now increasing physical health issues, but if I get my degree at 60 years old at least I made it. So, thank you for speaking out :)
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