Mental illness is a problem we encounter in the medical field that often comes with a stigma. Patients who are afflicted by a psychiatric problem are often marginalized and not given the time needed to appropriately help them. In primary care especially, we have a limited time to see a patient, diagnose a problem and treat it. This leaves little time for the counseling required for patients. This is simply not right and leaves the patient at a severe disadvantage in progressing towards improvement and freedom from the mental disease. Of all places, a primary care office should be a safe, trusted place to be honest and seek care.
One of the difficulties I face is the outside stigma that depression and anxiety are problems that are simply “in a person’s head” and if they try hard enough they can get themselves out of it. Often this is not true and the illness requires outside help through counseling and sometimes medication. Sometimes I see this in those of faith because they feel that as a believer in a God who loves them there should be no reason to be depressed. Because of this they deny the illness and sometimes delay or refuse appropriate treatment. Depression and other mental illnesses, however, have no regard for whether you have faith or not. Mental illness is due to abnormal levels of chemicals in the brain called neurotransmitters and require treatment through counseling and sometimes medication to help stabilize these levels.
A quick note on psychiatric medications. If your doctor feels that you will benefit from a medication, please consider it and don’t deny it just because it is a psych med. Everyone who has mental illness should recieve counseling and in some cases medication is needed. If you desire, it is completely acceptable to ask for a referral to a psychiatrist for an expert opinion on whether you need medication and which one would be most appropriate.
In exam rooms I’ve sat across from those suffering from depression to anxiety; from bipolar disorder to schizophrenia. I’ve been with those afflicted by a persecutory complex and followed them down the rabbit hole of who was out to get them. I’ve been in a psych ward at the VA and had a happily demented gentleman whip it out and urinate on the ground next to me. In all of these situations I remember a deep underlying feeling of compassion (yes, even with the man at the VA). It can be so easy to only see these people for their mental illness, but this does not make up who they are.
In my mind, it is imperative to convey the message that the person I am sitting across from is not defined by their illness. The illness is a problem separate from who they are and we as a team are in a fight against it. They are essentially a captive that we need to free. What I tell them will often go something like this: “I believe that there is a God who loves you. I want to let you know that you are a beautiful and wonderful child of God. The mere fact that you are a creation of God gives you worth. You are valuable. You are not your illness. We are going to fight and conquer this.” I intentionally take time to understand and counsel. This will often get me behind, but in these cases I am willing to allow this to happen so that the patient gets the proper care they need.
I hope that if you or someone you know has a mental illness, you are able to take this and know that you are valuable and that you have worth as a child of God. You are not defined by your mental health. Choose to partner with your counselor or doctor to fight against your affliction. If you are having thoughts about hurting yourself or ending your life please talk to a trusted friend or call the National Suicide Prevention Lifeline at 1-800-273-8255. Please pass this on to anyone you feel would benefit from this.