Image Credit: Image by teeveesee from Pixabay.
Disclaimer: This piece is satirical. On purpose. Please do not interpret all words literally.
Spoiler Alert: I sometimes have mental health struggles! And probably so do you.
TW: Anxiety, depression, occasional swearing, poop jokes (How inclusive is this meant to be?)
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Oh, hello there. How are you? Do you have a moment to learn about the uncomfortable details of my anxiety?
Surprise!! I have it.
Actually, we all have it. We may not label it ‘anxiety’. Maybe we call it stress or insomnia or ineptitude (when it’s really really bad).
I’m here as your friendly neighborhood ER doctor to tell you that it’s normal. No, really! I’m not just saying that because I have to. In the interest of full disclosure, this piece was not sponsored by Big PharmaTM (although if the makers of sertraline would like to step up, you know where to find me).
Around 20% of all adults in the US1 have some form of an anxiety disorder, which includes social anxiety, panic attacks, agoraphobia, hypochondriasis and just plain old, garden-variety generalized anxiety disorder; “GAD” for short.
GAD is a great example of how medical terminology and particularly medical acronyms can be very dumb. Imagine trying to nonchalantly explain to your Tinder date that you have a thing called GAD. Not even Gal Gadot could pull that off with charisma.
Anxiety in all its forms is actually estimated to be the most common chronic mental health condition in the US1. I’m convinced the number is MUCH higher than 1 out of 5, but I’m also pretty sure nobody likes telling themselves they have a “disorder.” What kind of weird and ridiculous word is that, disorder?
If you’re not in the medical field (or if you are), it might surprise you to learn that the incidence of anxiety & depression are actually higher in doctors2 than in the general population. Ironically enough, the stigma around mental health issues in doctors is like the stigma around these issues in your gossipy, digital friend groups, multiplied by like, I don’t know, 17.
Probably people don’t like to think of their doctors as having mental illness. But honestly, my doctor probably has high blood pressure and hey, I’m not judging. It’s a hard job to take care of your body, lady.
The reality is, when I became a doctor, I didn’t magically become a not-human-being, though it seems that was kind of the expectation.
So, in the interest of taking care of myself, I’ve decided that I shouldn’t feel embarrassed that I sometimes struggle with anxiety and other negative emotions. That’s just dumb! Or Wait; I’ll try to practice better positive self-talk:
My embarrassment is not super productive and is literally bad for my health.
There, much better.
Anxiety and depression are normal emotions. However, feeling so unable to acknowledge them that you begin to question reality and find yourself awake at 2am, eating Doritos, and somehow sobbing and laughing at the same time for no apparent reason? That is decidedly not ideal.
But also, sometimes Doritos are kind of the best medicine, you know?
So anyway. This is a thing that happens to me, a real-live actual doctor who does doctor things as her job.
Is your mind blown? It’s okay, try to act natural.
I’d say that I am not anxious about sharing this but… obviously I am. Please don’t read this and just like/love/panic-wow-face it as your (imperceptibly subtle) way of showing solidarity. Please don’t comment to tell me how brave I am, because I’m not (I mean thanks, but nah). I spent literal days agonizing over this piece, and then several weeks agonizing about whether it was too self-centered or unprofessional to share in this forum.
Unfortunately, even doctors still have to be afraid that disclosing mental health issues will cost them their jobs.
I’m not actually joking about that part. Pretty messed up irony, huh?
The stigma is real. The idea that being honest about struggling with anxiety or depression could negatively impact your work or relationships or whatever else¾ that idea is actually not an irrational paranoia that only you have.
So how the hell do I get patients to trust that they can safely confide in me about mental illness if I can’t even admit to myself that sometimes I have it? I’m no chef, but I know that’s not a recipe for success.
I can easily relay empathy to patients who come to the ER with food poisoning by saying things like:
Ugh. I’m really sorry you’ve had so much diarrhea that you’re up to your eyeballs in it. And you’ve vomited so many times the bottom of your toilet seat looks like some repulsive crime scene ¾except, you know, in a doctory and uber-professional sort of way.
But when patients come to the ER with symptoms that I suspect or even am sure are related to anxiety, depression, bipolar disorder, schizophrenia and other manifestations of extreme and/or chronic stress, I am so afraid of relating to them TOO much that my words of comfort ring hollow.
And they know it too. Because they, like I, feel very ashamed.
I am often afraid to even mention those capitalized words ‘Anxiety’ or ‘Depression’when treating patients because the stigma that we as people ALL feel is so unbearably potent that we would rather act personally offended by the words than admit it’s something we can all relate to.
So instead, if you’ve stuck with me this long; if this lengthy mass of words resonates with you in any way, form, or poop-shaped emoticon, please…
Take a minute to put on your bravery cape and talk to somebody about it.
You can even just share this rant if you want ¾it’s okay, you’re not lazy, even though I bet you’re sitting there contemplating it and telling yourself that you are. You’re so lazy you can’t even click a share button.
Wowza. Look at how anxiety makes us treat ourselves.
Really though, share it wherever you want. Print it out and tape it on a cool looking tree in the park. You have my permission. Tell your kids, tell your wife, tell your best friend or your worst friend or your boss’s weird cousin at the holiday party.
As my partner likes to say (in a way that used to make me roll my eyes but now I realize is probably the sagest advice I ever heard in my damn life):
“It’s only awkward if you make it awkward.”
So true it hurts and I don’t even mean that sarcastically.
If you ever feel like you’re struggling with anxiety or depression, and you’re worried (ha) that it’s reaching a breaking point, PLEASE go see a doctor. Any doctor. If it’s too awkward to see your doctor, see my doctor. I’ll give you her card.
Don’t have a doctor? Get one.
As an ER doctor, my professional medical opinion is that primary care doctors are THE. BEST. DOCTORS. for this and any other unsettling human dysfunctions you’re experiencing.
But I promise I won’t ever be mad if you show up in the ER instead. Mental health can be an emergency too.
I love you guys, and I don’t mean that in the fake-cheesy social media way. I mean it like I became a doctor because I want to help people. And if talking about my own adventures with the ups and downs of mental illness can normalize it even a teensy tiny bit, I’m in. Oh! And one last thing – because if high school taught me anything ,it’s that the cleverest way to end an essay is with a thoughtful quote. Here is one by my favorite author and secret personal hero, Tom Robbins:
“I see nothing particularly courageous in risking one’s life. So you lose it, you go to your hero’s heaven and everything is milk and honey ’til the end of time. Right? You get your reward and suffer no earthly consequences. That’s not courage. Real courage is risking something you have to keep on living with, real courage is risking something that might force you to rethink your thoughts and suffer change and stretch consciousness. Real courage is risking one’s clichés.”
So take care of yourselves. Because if you don’t, I’ll have to. Just kidding, but also not really.
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1. National Institute of Mental Health
2. Beyond blue study