Doctor REACTS to Dr Mike on Trauma and Mental Health | Dr Elliott
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- เผยแพร่เมื่อ 21 มิ.ย. 2024
- #doctorreacts #drelliott #drmike #mentalhealth
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This Doctor REACTS video is looking at Dr Mike's latest video where he addresses some potential controversy over his comments about the link between mental and physical health. Can mental health cause physical symptoms? Did he get it right or did he get it wrong?
Let me know what you think!
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Frankly wild to me that someone who works with athletes doesn't think the intense stress of being an elite athlete couldn't be causing additional issues or exacerbating other issues.
He does!
exactly ! it’s wild…
@@DreamIt.PursueIt.AchieveItthey're referring to the orthopaedic surgeon who confronted Dr Mike, saying he wouldn't dream of considering mental health as causing issues.
@lexwithbub omg yes!! I thought about it afterward lol I had a duh moment lol.. thank you for reinforcing that!
@@DreamIt.PursueIt.AchieveIt no worries. I misunderstood at first, because it's not brought up until later in the video. 😊
Two words: informed consent. I have ADD. When I first talked to a psychiatrist about medication, I asked about my chances of carrying a healthy pregnancy. He LOOKED IT UP, and shared with me that it is not throughly studied, but all research so far shows this class is safe. He inspired me to participate in a study while I was pregnant with my healthy, happy child.
Absolutely spot on to look it up. I do it all the time.
It’s funny because Dr. Mike actually did a TED talk a while back on the power of a doctor being able to admit “I don’t know.” Fascinating stuff if you’re interested! And congrats on the baby!
I also think that it's a very delicate balance for GPs to strike to say "it's psychosomatic".
Women have been dismissed for so long by being believed "hysteric"; a lot of conditions that affect women more frequently have no conclusive tests. Stuff like ME, fibromyalgia, ehlers-danlos syndrome... All these diseases could so easily be dismissed with an idea of "it's psychosomatic" or "you must have depression". So I think that's where some of the negative reactions come from.
Oh I agree entirely. Psychiatry has perpetuated the divide between mental and physical illness so we as a specialty have to look in the mirror too
@@DoctorElliottCarthy i'd say it's not only that but (if i understand op correctly) the misogyny that was very thinly veiled by "hysterics"/"hysteria" now is a bit more thickly veiled by "psychosomatic" because there is so little medical non-psychiatric research done with women as subjects. so in fact illnesses/presentations that could be explained "anatomically" or "structurally" (as opposed to "psychosomatic") with more research on/with women are brushed aside as "psychosomatic".
as an aside: i agree with (almost) everything dr. mike and you, DrElliott, say - mental health is a huge factor and very often overlooked, so i definitely would not be someone to leave toxic comments on a video like that! it's whataboutism: dr. mike was speaking about the important factor mental health plays in somatic symptoms. he also has spoken (quite a few times actually) about sexism in medical research - but that is a different topic. and leaving such comments does a disservice for many people.
explanation about all the quotation marks: since the chemical situation in the brain is technically anatomical/structural and, i'd argue, almost all somatic presentations, even a broken arm, have psychological effects (like the trivial: "i am helpless, i am dependent on other people, i have a hard time accepting that") or can be caused by psychological effects/states, the demarcation between "non-psycho-somatic" and "psycho-somatic" is arbitrary. but i understand, of course, that we need this kind of vocabulary for communication about these things at the moment.
^ this. I think this is where most of people's discomfort with Dr Mike saying this is coming from.
And I think much of that is the clear difference between "oh, it's all in your head, no testing needed" vs what Dr Mike is saying which is, "let's make sure we investigate properly, but also not automatically rule out the role that mental health might play in chronic pain"
Agreed! It's a balance between dismissive and understanding psychologies role
My worst experience with a psychiatrist was the one who diagnosed me with BPD. I was using alcohol to self medicate at the time. I was trying to be honest, so I was candid about my drinking. He told me that since I was abusing alcohol I couldn't get any mental health help till i was sober. I explained I didn't think I could do that till I got help. He pretty much told me 'tough luck' and gave me the numbers for some charities that help with alcohol...I tried talking to them. But since I was chronically self injuring and suicidal, they said they couldn't help.... it was...awful. to say the least.
My best experience was... something little. But meant a lot to me. I'd had a baby and was still breastfeeding. And my mood was starting to drop. I knew I needed back on antidepressants. I came with print outs about what ssri's are safe with breastfeeding and willing to defend my decision that stopping feeding would be VERY bad for my mental health. But the GP was just 100% knowledgeable and on board and supportive. It meant a lot to me
My GP told me exactly this about accessing mental health and substance abuse. He said it sucked and he thought it was wrong but that that was the reality of it.
Before being diagnosed with bpd, I was struggling with alcoholism and drug addiction as well as sh (still struggling with sh) and they said they couldn't help me until I got sober for more than 6 months because they weren't sure if the low mood is caused by my alcohol and drug use.
When I tried kms last year via train (was my 3rd attempt) that's when I got admitted to the psych ward and got diagnosed with bpd and then managed to get proper help after that. It's insane that in order to get help when you're addicted is that you have to stop using which I think isn't fair.
That's maddening. I legit feel like they should have their license taken away. That's a doctor that just doesn't want to actually do their job. But, sadly, that mentality is used to deny assistance in all sorts of ways. You're not allowed housing assistance unless you're "sober", but it's a hell of a lot harder to do that if you're living on the streets.
While I agree it’s hard to really work on issues when you are dealing with any sort of addiction, the process of BOTH needs to be started at once. For me, it was a severe ED. The real work wasn’t done until my weight was stabilized in a healthier range and my eating habits were less toxic, and honestly the brain is in a very nonconducive state at that point. BUT therapy was started on DAY ONE, and I could not have fought the ED at all without it. They are sointregal that you cannot split the two and deal with them separate. You cope with alcohol, you aren’t depressed BECAUSE of alcohol.
I’m so sorry you got the “just tough it out” by a medical professional. That was a great disservice to you, and was wholly ineffective and goes against all scientific research of how to combat these issues. How unethical. I’m glad you had another member on your team that treated you care and compassion and looked at it from a holistic approach.
My mam would have already been out of her house, and had help but she was told the same as you.
Can't help until you stop drinking 😔
She's now got a sober coach who Is slowly taking her off. Said there was no way she'd have gotten off herself because there was a high chance it could have killed her
I really like that Dr. Mike brings up the importance of mental health for your physical health often. I think it’s often overlooked
I've had psoriasis since I was 5 years old, and I developed arthritis around 13 or 14. I've spent most of my life going to dermatologists every six months (even more often now because I also decided to get alopecia areata 4 years ago 🙃). Every dermatologist I went to acted like, and some even said, "It's just psoriasis. It's not like it's something serious." Meanwhile, I grew up flaking skin everywhere, uncomfortable, itchy, bled all over everything all the time. My scalp was completely covered in super thick plaques to the point where just washing my hair was painful some days. But to them, it wasn't a big deal, it was just some skin thing, here's some steroid cream, see you in six months. That all changed when I was 19 and found a new dermatologist after moving. It was mid-summer Alabama, and I was wearing long sleeves and long pants. He came in, asked me about my history, and then he said, "It's obvious the emotional toll this has taken on you after all these years. It's sweltering outside, and you're covered head to toe. I'm going to do everything I can to fix this for you." 20 years later, I still go to his office, although I see the PA now. I will never, ever, ever forget how he validated my entire life in those few sentences.
And to add to what you, Dr. Elliott, and Dr. Mike are both saying, two years ago, I went through a great deal of family and work stress, and it came out in the form of a pretty severe arthritis flare. It's been under control for a long time thanks to biologics and weightlifting, but at that point, nothing was going to help until my stress levels lowered. I can attest to the fact that, even though the pain is physical, the cause can very well be mental state.
Thank you for all you do, Dr. Elliott! You're an asset to the TH-cam community and the world at large
I think this is a really great example. Thanks so much for sharing.
Dr. Elliott, I just wanted to say I’m so sorry for the disgusting homophobia you referenced in the beginning of your video and my heart breaks for you that in 2023 you still have to contend with that. It’s unacceptable and vile. I was getting dressed while listening to this video and put on my rainbow socks in solidarity. I am not a member of the community but a huge ally. Best wishes and keep being you. You have tons of fans! ❤
Your socks wont change anything except you feeling virtuos for wearing colorful socks
@@earlgrey2130 However, letting people *know* they're wearing the socks, and why, shows those people there is support, which does help.
Jfc why do you guys think that doing things like putting on rainbow socks or hanging a rainbow flag matters to us?
@@OPGardevoir it was just supposed to be a show of respect, dang.
@@TheUnknownMissAusten just being a deing a decent person to us is enough. Doing things like that is superficial at best
I had the kind of reverse situation: I talked to my neurologist a few years ago (I'm epileptic) about how I was feeling suicidal. I've been through this before when I was a teenager, so I've had experience with the feeling, and was certain that something physical was wrong with me causing the feeling as opposed to something that needed only mental treatment. My neurologist, when I discussed this, thought it was more likely purely a mental health issue... but she's actually a good dr and listened to me, so she said, even though it was more likely I was depressed, she'd try testing my blood because it was also possible I was low on B12. Turns out I had like close to zero B12. I started getting B12 shots and almost immediately started dreaming again after 5 years no dreaming, which she said probably meant I hadn't been sleeping well for those five years, which probably contributed to my feelings of suicide.
I'm asexual and have some body dysmorphia in relation to my sexuality. It became so bad that any time I had to do a physical exam, I would vomit before or after the exam. I was either anxious to have the exam before or felt disgusted and violated after. I expressed this to my OBGYN and she told me that that was a normal reaction to have. That's just part of being a woman. The anxiety at the thought of going to the doctor and being sick turned into panic attacks. No one believed how bad it was until I was in the ER because I thought I was dying.
If she thinks being anxious and disgusted to go to the doctor is "just part of being a woman", I actually feel sad for her, cause her own experience of being a woman is probably not great.
And that's part of the problem : doctors too live in a world of mysoginy and violence and mental health stigma that they have internalized and normalized...
I had a big issue where doctors immediately presumed that my symptoms where mental health related, not physical and therefore not "real". For 6-8 months I was 'diagnosed' with being stressed for exams when I actually had bad post viral fatigue and a connective tissue disorder...
I ended up figuring out what I had myself and laid all my symptoms out to the fifth GP I'd seen to finally get a referral.
You're highlighting a really important point which is that if mental health is at all a factor, that it somehow lessens the legitimacy of the issue, which is an all too common belief but so wrong
hi. im suffering from chronic fatigue syndrome and some other symptoms. i dont know if post viral fatigue caused it. how do u find a good doctor who takes u seriously? please i need help. everyone around me is saying its all in my head despite me feeling physical symptoms
@@DoctorElliottCarthy I completely agree. Another issue is when you're trying to get a diagnosis and are advised to try yoga or meditation but not believed, your mental health can become negatively affected. However, it's impossible to seek help or guidance regarding mental health because then it invalidates any physical symptoms and can prevent you from getting a diagnosis or resources. There is difficulty looking at a person as a whole and preferring it distill it down to one issue (at least in Ireland).
@@sekischro5093 I'm so sorry that this is happening - that's really hard. For me, I personally found having someone to help document and track my symptoms at the time and also to attend the appointments with me really helped. Having a physical, objective log can help display your symptoms. I'd also recommend describing them objectively and without emotions as doctors tend to take you more seriously when you do, the other person can really help with that!
Yes I agree absolutely to this. I come from this with a biomedical PhD student perspective (hello I majored in neuro) and a patient perspective. My mental health issues came before I started experiencing symptoms (severe fatigue, joint pain) of a genetic connective tissues disorder (Hypermobility spectrum disorder), so I was often shuttled to the box of psychosomatic illness, depression/anxiety (which I have but the fatigue felt very different compared to fatigue I would experience during depression), and fibromyalgia before getting a proper diagnosis and medication for my fatigue. I was told by doctors and therapists to get proper nutrition, exercise, and spend more time in sunlight to “fix man fatigue” but none of them worked. And these symptoms occurred while I was getting treated for my existing mental health disorders. I had to somewhat figure it out myself and get the proper tests before I got the right help. And even now, good help is hard to get. Something I worry about is how some badly trained doctors would jump to “your symptoms are mental health-related and psychosomatic” just because patients have a mental health history.
I think it is important for mental health stigma to reduce, but it is also important not to rule out rare disorders if the mental health treatment approach doesn’t work. I feel like doctors should provide more options and be willing to say, “we can try X and see how it does.” If mental health interventions didn’t work, keep investigating because it could be a great imitator disease like lupus or EDS because missing a diagnosis of lupus for instance could have significant consequences. Leave avenues of investigation open!
I have debilitating fibromyalgia and I just did Dialectic Behavioral Therapy which works similarly to how Dr. Mike described. It hasn't made my pain go away but it has made it easier for me to deal with. A more apt analogy would be that it is like if you have a heavy weight supported by a net, then you need to make sure all the ropes are strong. By working on your mental health you are strengthening the whole net so the weight is easier to bear.
I had just been diagnosed with bipolar by my psychiatrist who recommended Lamotrigine to me. When I met with my GP to get the script, my doctor read my new diagnosis and said “so just mood swings then” it was completely invalidating and I was so hurt because it’s been a scary new diagnosis to navigate and it was just put down to moodiness. Lucky my clinical psychologist has been really supportive of the new diagnosis!
I was suicidal, had plans but was so embarrassed and ashamed to admit it…. I did to the psychiatrist, I was told to “do it, each person has to do what they’re going to do”.. She obviously couldn’t tell I was genuine and had it not been for a strange coincidence (that saved my life), I would have done it.
@foolishlyfoolhardy6004 thank you! Bless you!!
I was writing in a journal that I was self harming with cutting. My friend stole the journal, gave it to my parents, who gave it to my therapist.
I had a session with her and she briefly asked what the scratches on my arms were. I said from my cat. That was the end of it.
I went home that day and carved long gashes into my legs with a box cutter. Over twenty years later, still have the scars.
Mind you, there was blood on the pages of that journal. I should have been committed (dunno if that’s the right term).
I don’t mind the scars any more. I look at them and say, “Still here!”
My gp as a teenage was awful. Apparently a 13 to 17 year old girl having server periods we're they were bleeding 10-15/28 days anemic was normal. After having my kids I found I had endometriosis and PCOS. At 17 I couldn't sleep, felt awful, didn't want to get up. I pretty much missed half of year 11 and 12 due to feeling shit. He said that's completely normal for a teenager. At 24 I was diagnosed with bipolar. At 8 I started dislocating my joints. I had 5 surgeries from 14 to 25 to be diagnosed with hEDS at 38. It felt like it was thrown in the can't be screwed basket. Now at the emergency room if I go in I get put as a drug seeker bacuse to get my dx of bipolar I tried to harm myself. Nearly 20 years on I'm still slapped with that label. It's horrible. Really doesn't help with your mental health. I'm so glad my GP is amazing and listens, helps and guides.
Always ALWAYS if you have to go to the ER, have your GP or specialist provide you with a referral letter to present to ER doctors outlining your condition and/or pain requirements. That way they can't accuse you of drug seeking, the insinuation of which is rampant and reprehensible. Which, honestly, most GPs should anticipate because they know how the "system" -- especially in the ER -- works and the biases that can develop in a burned out and jaded medical vetting situation.
And surely by now, psychology has advanced enough that slapping a "psychosomatic" explanation on everything because the medical system hasn't bothered or cared to research it (too much money don't ya know...) should have ceased. Too much emphasis is put on pain. "What's your pain level between 1 and 10" is a standard question which is basically meaningless, when pain tolerance varies between people and there are significant differences in disease and symptom presentation between the sexes. That's why so many women's pain is dismissed, and they lose their lives as a result. Or go for years without a proper diagnosis and as a result get no treatment and exacerbation of disease. In all cases, inexcusable.
@@sadee1287 not in Australia. I recently had a knee replacement surgery and had to get a dr to sign off my pain meds because according to them my normal pain meds were enough. It was hell. I was glad to go home and see my GP who helped me. Im stressing about my other knee. And them having to give me my meds for my bipolar was so screwed. I had to justify why I was on them every single night. My morning dose was fine.
As a teen I started having issues with fatigue. It got even worse in university, no matter how hard I tried I couldn't stay awake during lectures or on the bus. I would have classmates asking if I was okay and looking at my old notes you can see all the times my pen slipped when I nodded off (every few words on a bad day). After a bunch of tests, I was told there was nothing wrong and it was probably "just my depression" and given no further course of action. I had already been receiving mental health treatment for years and obviously that wasn't doing anything to help my fatigue. To this day I don't know how to manage it. I'm fully open to the possibility it's tied to my mental health, but the doctors told me this as if the fact it was a symptom of mental illness meant it wasn't a real problem and I just needed to choose to stop falling asleep or stop being depressed. For years, whenever I went into the doctor for anything it felt like all they saw was a mentally-ill teenager, and therefore every issue I had that they couldn't immediately diagnose had to "just" be mental illness and needed no attention. Later on, I got a diagnosis for an immunodeficiency and I can't help but notice I often get taken more seriously now. It's like everything I say is automatically more legitimate because there are a couple abnormal numbers on my blood work the doctor can actually see. But back then I was sick and scared and trying to navigate the adult medical system for the first time, and all I got was repeatedly dismissed. Years later, my relationship with going to the doctor is still fucked up. That being said, credit where credit is due to my psychiatrist who even if there was a problem he didn't know how to help me with (such as, maybe a bit ironically, my fatigue), always made me feel heard and taken seriously
Narcolepsy?
check for apnea? add and autism can fuck with your sleep. hypovitaminosis too.
did you have a viral or bacterial infection before that started? (like influenza, mononucleosis(kissing disease) strep etc?
bc me/cfs can be a side effect of an infection - the risk is increased for covid, 10% of covid infection have some form of long term damage
I can understand the backlash, but it's not because of what Dr. Mike actually said. It's the keywords - pain and mental health.
By the time we got to the end of the clip, I was nodding along. I agree with his approach. He sounds like he's collaborative with his patients, which is such a breathe of fresh air.
At the same time, as someone with chronic pain, I tensed up at the first part. If you go to any chronic pain, ME/CFS, Fibro, EDS, POTS, Endometriosis, Lyme Disease, IBS, etc, etc, etc support group, you'll see hundreds upon hundreds being shuffled off to psychiatrists, insisting _all_ of their symptoms are psychological. People are being diagnosed with factitious disorder by the droves - a supposedly rare illness. We're going for years suffering in our illnesses before getting a proper diagnosis, and it's only gonna get worse now that millions have Long Covid.
Having to fight to be heard by the people that are gatekeeping your health (and therefore your life) causes a lot of trauma too. So while I agree with what he originally said, agree about how "the body keeps score" (trauma showing up later in the body), and definitely agree that people with chronic illnesses need psychological support, there's some keywords in there that are gonna get a lot of people's hackles up before he can even get to the next sentence.
It might be helpful for him to consult with those that work with those with chronic illnesses/chronic pain, to understand why this riled so many people up. It could be a really helpful and validating discussion to have publicly.
So well said!
I couldn't make it to the end to see his improvement. He's done a lot of problematic stuff over the years, so I don't have a lot of patience. I also have significant medical PTSD due to being a chronic pain patient, as you said. 16 years (and counting) of doctors discounting my CRPS (a likely autoimmune disease) as caused by my abusive childhood. They ignore the years of therapy I did to work through that stuff, the fact that my mental health is pretty good most of the time - especially for a person who doesn't remember what life without pain is like. It's even worse if I use my wheelchair, they look at me as if I'm a waste of medical resources. The ableism is horrifying.
I have a great GP now, some treatment for my pain, but everytime I see a new specialist/doctor I get so stressed out - and I'm a pretty laid back person. My partner says I turn into someone he doesn't know for a few hours/days, it really freaked him out the first time. Now he comes with me, so I can enjoy some of his male privilege :) They listen to what he says about my symptoms more than when I say it, so I'm glad he's willing to help out.
My worse experience: I was having a lot of health problems (vomiting, weakness, dizziness, falling, and more). I was being sent to a bunch of specialist and they were in the process of running tests. My PCM sent me to an internal med doc to try to keep track of all the specialists. I also have anxiety and was on meds for it (had it for years before these symptoms started). I saw the doc and she said she thought my symptoms were 90% mental and only 10% physical, and that I should just go on walks (which I was already trying to do). Yeah, a month later I was diagnosed with an immunodeficiency, and a couple of months after that I was diagnosed with POTS, a motility disorder, and more. But, for a few weeks after that interaction I was struggling feeling like it was all in my head. I will say, my mental health can affect my chronic illnesses, and my chronic illnesses can affect my mental health so it impacts it, but I did not just make it up!
Personally, I agree that obviously mental health and physical health are heavily linked. The only thing I don’t like is that a lot of doctors go between 2 ends of the extreme. Before you have obvious mental health troubles, they completely deny mental health existing but when you do have mental health problems on you medical chart, they blame every single health problem on mental health (at least in mine and my friend’s experiences). I had doctors completely deny my health problems as they didn’t believe that they were caused by anything other than my depression, which I had been relatively successfully treated for by this point. I’ve had life threatening problems dismissed and been judged because of my depression and anxiety. I watched your video where you reacted to skins and commented on how modern day psychiatrists don’t act like she did, however that is the exact same level of care that me and a lot of my friends received from psychiatrists working under CAMHS. I think that your approach to psychiatry is incredible but occasionally it feels like the problems of psychiatry, specifically in the UK, are dismissed in your videos. I know a lot of the depictions of psychiatrists seem dramatic but that is a reality for a lot of people (at least in the UK under CAMHS. I even had CAMHS out me to my parents after repeatedly asking for it not to be mentioned and it was dismissed by everyone who I reported it to
It took me 8 years to get diagnosed with my connective tissue disorder, dysautonomia, and gastroparesis because doctors accused me of faking/it all being related to my mental health. i think Dr. Mike was trying to be helpful, but he needs to be aware that most doctors are not like him, especially in America. Most doctors do jump to symptoms being "psychosomatic" and it hurts patients long-term. I think that there is a mental health component to every health condition (my conditions worsen with my mental health), but there is also a lot of trauma and pain in people with chronic illness/pain. Just. A very touchy subject
I had low mood a few years ago, so I went to my doctor. I was very overweight at the time, which I agree didn't help with my mental health at the time. She was quite abrupt in asking "is everything okay at home?", which in itself is a good question to ask, but the manner in which she said it made me feel like it was an accusation of some kind. After some blood work, it turned out that I have hypothyroidism, which was contributing to my low mood. Now I am on levothyroxine, and it has definitely made a difference.
Such a simplistic way of asking a hard question... you could've been happy and still be medically sick, same as you could feel terrible and not have a single illness. I think the best approach should be something like "I'm going to run several tests and imaging scans to see if we can find anything that explains this low mood you're feeling. Meanwhile, do you think that there could be a psychological component that's aggravating this condition? would you like to discuss this possibility or to be appointed to a psychologist?" IMO that would've been way better than "is everything okay at home?"
@gustavoraffo489 Thank you for your reply. I am a mental health nursing student, and I am happy to say that we get taught counselling skills, communication skills, etc.
I totally agree with you. Being more mindful when talking to a patient is crucial. Very few people want to be in the hospital, and we are very vulnerable there. Bedside manner is incredibly important when conversing with a patient because we are trusting them to make the best decisions for us, and if we aren't comfortable, we are less likely to confide in them and possibly leaving out crucial information. I fully understand that the clinician who dealt with me was not a mental health professional, and may not have been as informed how to ask that particular question empatheticaly. By no means was she bad at her job. She was very accommodating. But her interaction did stay with me.
I wish that Dr. Mike hadn't been such a disappointment during early covid times. While the CDC was begging people to use caution and maintain a small bubble of people, don't go out partying, he went out on a party-yacht with his buddies.
He may have good general medical knowledge to spread, but he really let me down then. He's a doctor. That should have been the easiest thing for him to say "no guys, not yet".
He apologized and from my knowledge he did not engage in such behavior again. When people make mistakes or fall short you don't have to hate them or write them off permenantly no matter what, period, end of discussion. You should judge other humans on their ever growing character growth - "is this person changing or they staying the same?"
Glad to hear it isn't a repeat type of problem. Maybe he has earned forgiveness. But I don't believe in forgetting past offenses. If he's better, great. I don't *hate* him. I have severe disappointment, and he lost trust. I do hope he's back to good-doing and not disappointing.
My first experience with psychiatry was terrible. I was 15 at the time and the dr spoke to me like I was about 8 (this is a paediatric psychiatrist btw so its not like he wasn't used to dealing with kids, teens and young adults). I didn't feel he listen to me and he spoke with my mum mostly, who at the time didn't have any idea what I was going through and thought my mental health was just "ungratefulness". He told me he was mainly going to be hearing from my mum as "she knew me better then I did". He then prescribed me a medication in a dissolvable form, because he assumed I couldn't swallow tablets, which I hated the taste of and made me gag every day when I'd take it.
The medication made my depression much worse and I begged them to change it after trying to 'give it time to work' for over 8 months. I eventually refused to take it anymore and they finally put me on something a better, which still wasn't right for me but didn't actively make things worse. As I'm now going into medicine/health I understand more and more what a bad prescribing choice the first medication was for me and it is clear that nothing I had said was really taken into account at all.
Last year when I finally met a doctor, who had a very similar story to me, who really listened to me, I cried. She explained that a lot of psychiatrist will just prescibe the same 2 medications kids because that's what they're familiar with, even though there's no evidence that they're safer or better for children in anyway, regardless of their clinical presentation. She recommended much better medications for me that are actually working, and the difference is huge.
Happy to share and totally agree with you both. I had a house fire 5 years ago which triggered a load of digestive issues due to stress. Tests found nothing physical, so I was discharged. It was obvious to me it was linked to stress, so when it didnt get better I pushed and asked for further tests. It has taken 4 years despite starting every consultation with "I had a house fire" before a specialist thought to link emy traumatic event to physical symptoms and look for brain-gut disorders.
I'm still undergoing tests now and still don't have answers, but I think asking the right questions and thinking holistically would improve diagnoses (or exclude others).
Great analysis and I think you and Dr Mike are definitely forces for good!
My worst experience with a doctor was a gynecologist who didn't take me seriously when I told her I was in pain during an exam from using too large of a speculum and simply telling me it was because I needed to "relax." I was particularly upset because she was a female gyno. I was late teens/early 20s, but it was not my first gyno visit and I knew from both experience and my regular gyno (this was another in the practice) that it was not usually comfortable but was not supposed to hurt. I felt like I was being stabbed in the cervix.
As a provider, I am a mental health therapist who primarily works with clients with eating disorders and I have heard SO many awful stories from clients of all shapes and sizes about not being taken seriously by primary care providers. Lots of clients in larger bodies being told they need to lose weight rather than being listened to about any concerns, and clients in smaller bodies being dismissed and told they "look great" even if they bring up disordered thoughts or behaviors. Dr. Mike himself has echoed a lot of comments that perpetuate medical fatphobia, when what is needed is a weight-neutral approach.
Sometimes women who don't experience those issues are more dismissive than men. I had a female PE teacher who went on maternity leave and told the male teacher not to let girls use their periods as an excuse not to participate. I have PCOS that was not being treated at the time. I had horrendous periods. My cramps were so bad that when I had a baby later in life, I didn't know I had gone into labor because I had expected contractions to be worse.
I have major depressive disorder and pcos. Around the time I turned 30, I started noticing my depression getting worse when I was about to start my period. It was noticeable and debilitating. I went to my psychiatrist who told me since it was connected to my menstrual cycle, it was caused by my pcos and I needed to see an endocrinologist. The endocrinologist told me it was my depression causing my depression and sent me back to my psychiatrist. I went in circles for MONTHS trying to figure out a solution. It ended with me sobbing my general practitioner’s office begging her to help me. She said that regardless of the specific cause, losing weight would help reduce symptoms. I lost it. I asked her for specific actionable steps I should take to do that and then listed everything I’ve tried to do. She was speechless and couldn’t give me an answer.
It turns out my uterus was full of fibroids which was causing pain and chronic fatigue.
Ever since I got my depression diagnosis, everyone assumes depression is the cause of any and all of my symptoms like chronic fatigue.
Wow I had a very similar experience!! Went to two GPs and a therapist about how for the last 6 months I would feel suicidal in the 3 days before my period and then as soon as my period started the feelings would just disappear. One GP (a woman) told me it's because I'm getting close to 30 and that's just what we have to deal with, which shocked me so much. Eventually on my sane days I did a bunch of research and found some herbal remedies that usually I would have sniffed at, but given there is so little research in this area and I was desperate I thought it was worth a try. Long story short, they worked well for me. But I'm lucky that I have the time, money and education to be able to try that - many women will just be left without any options. Let me know if you'd like to know what the herbal remedy was and I'll dig out the box from my bathroom! Even though it's herbal and easily available, I was told it can counteract the effects of the pill so definitely do your research before taking it.
Tbh I went off Dr Mike a few years ago because he just can not phathom that medical gaslighting is real and common. Thr comments he brings up saying "they're saying I gaslight my patients" DONT SAY THAT. The second one is saying they WISH their doctor took the approach he described.
He seems to always dismiss the experience of fat people, disabled people, people with chronic illness and women when it comes to medical gaslighting and gets defensive.
Yup, I'm also not feeling him. I've always found that the way he talks about overweight and weight loss is very dismissive.
@@MichiruEllyep nuance is good .... but don't point him to the social economic factors not controlled for in obesity outcomes studies ect.
I'd hypothesis that weight stigma is probably a driving g cause of obesity too
Same - I went off him for the same reasons.
It was the covid scandal for me.
@@carr0760 oh wow, just found his well buried "apology" video...!
I actually kind of found you through a sort of pipeline that started with Dr Mike! I watched some of his stuff for a bit, and I don't mean to say this as a dig on him but rather as an appreciation for you, but I am an autistic person and at the time I was watching him he had some takes on ASD and "treating" it via ABA that had me feeling icky. But I love educational content like his so I started looking for other channels and here I am! Being queer myself you better believe I felt at home right away on this channel. I don't have any hate for Mike but I much prefer it here and I'm not going anywhere anytime soon.
Well I'm happy to have you here
Thank you so much for sharing your perspective. I think this is what Dr. Elliott means by conversation. One thing that gets flattened in the discussion around trauma is that it often flattens the conversations to make the person who has trauma the problem and the thing to fix. It's hard to do in. a medical setting but medical professionals need to acknowledge systems that inflict trauma - the microaggressions and macroaggressions of living in a world that is designed to deny a marginalized person their humanity. It also erases strength and resilience as well. It's one of the reasons I respond to Heartstopper - that kids like Nick and Charlie have a lot of strengths like empathy and strong relationships with certain people and also have vulnerabilities.
This conversation and commentary is super valuable. Thank you for spreading the nuance and collaborative spirit.
I love the open and clear and humble way that you speak. Very valuable, and very educating to listen to. Thank you so much for your labour! This is top quality content 🏳️🌈🏳️⚧️💙
My problem with the sentence "I'm not saying it's all in you're head" is that for some reason, I really, really emotionally perceive that as "it's all on your head".
It's the same effect as if I said "I'm not saying women are bad drivers" kinda implies that I'm about to say that women are bad drivers.
So yeah, the sentence I would respond much better to is something like "I'm not seeing any physical cause for your pain, so I want to explore an other avenue. In general, how have you been feeling lately? Has there been any particularly stressful times?"
I love what you said about the overemphasis on trauma when talking about mental illness. Extremely well articulated. Chef's kiss.
Love seeing content about Dr. Mike. He gets a lot of controversy because he makes mistakes like anyone, but he never has any malicious intent. Quite frankly, it is a nothing short of a miracle that he still continues to maintain that amount of integrity despite his popularity.
I'm autistic. I have cPTSD. I was yelled at by an urgent care doctor who explained loudly that the object stick in my throat was non-existent. The object, that didn't exist, took approximately 2 weeks to rot and break down in the back of my throat. I will never see a doctor again.
I confided in my Dr about SA while also discussing anxiety and he was so calm and listened to everything I was saying. He said he was going to refer me for counselling but made it clear that I could talk about the SA or not if that was my preference. He didn't push me to report anything but was very supportive and encouraged me to share with my friends so I had a support system in place and I was able to share with some trusted friends
3 years I'd been dealing with generalized pain. muscular stiffness (whole body on spasm, basically, traumatized several massage therapists and PT). terrible fatigue. double vision. loss of fine motor skills. pins and needles in hands. Saw two ophthalmologists, one neuro-ophthalmologist, one neurologist, two internists, and one rheumatologist. 2 MRIs, 2 EMG, and about 5L worth of blood tests after, I got referred to a psychiatrist. 3 months on duloxetine - I feel like I've been given a full-body transplant. I swear my muscles have never been this squishy in my life. The psychiatrist was the first doctor to say: hey, you may or may not have something physical going on with you, but you've been dealing with this for too long - we need to try something. Specialists saw negative tests and told me "everything is perfect, you're doing great" meanwhile I could barely move 😅
Good example:
I was at my first appointment at a new dentist office. I had been very anxious for the past few months and on top of that I was in a lot of pain and was trying to rule out what it was. The new general dentist saw me very kindly and after 5 minutes asked me straight away if I was feeling anxious. I said yes and she carried on checking my teeth and being very careful. After that I had to see a different kind of dentist and when I sat in the chair I immediately started having a panic attack. Crying, tunnel vision, tingling, fast heart beat... The dentist looked at me and just asked "Are you having a panic attack?" I nodded yes. He said "That is totally fine, do not worry". He kept doing his things and every now and then just asked me simple yes or no questions (so that I could nod) very calmly: can you talk?... Is your heart beating fast?... is there anything from my tools that scares you?...
After what felt like an eternity (I have no idea how long I was in that state, I just let it roll), he carried on telling a story about him knowing what I was feeling like because he also had had panic attacks (went on to give an example). I just really liked his approach, because all the time he was very calm, putting me at ease, not nagging me with things like "stay calm, it will pass, it's nothing" and those kinds of weird questions. He just tried to get a sense of how I was feeling and acknowledge that. No hurry. Also, amazing how dentists, of all doctors, knew what I was going through and knew how to deal with it (maybe comes with the job). At the end of the consultation, the first dentist that saw me also gave me a letter to give my family doctor suggesting I see a mental health specialist.
Bad example:
I went on to see my family doctor with the letter from the dentist. I was in a terrible anxiety state, on the verge of a panic attack, could barely talk. I went there, explained that I was feeling very anxious, what had happened at the dentist, and gave him the letter. My family doctor read it and after a minute or so just asked a few questions like: is everything ok at home? things are ok with your parents? (I live with my parents), and just very general questions about my daily routine. But everything was mainly ok, the problem was me, not things around me. The doctor then said "The letter suggests you see a psychiatrist, but I don't think you need it." He then prescribed anxiety medication, a low dose, and sent me home.
When I left, I blasted the panic attack while on the street, just crying and letting it go (don't really know why I stopped it at the office, guess I was just trying to look ok). I took the medication for 1 week. After that week I realised that not only he didn't explain all the details about my medication (some anxiety medication might be addictive), but also didn't say for how long I should take it. I guess I wish he had asked me more questions, more about how I was feeling. At the time I couldn't talk a lot and my mind was just racing and couldn't think properly. Also, here where I live is really hard to get an appointment or even have the family doctor answer an email (public health system). So I felt like he just discarded me and my problem and didn't take seriously the letter from the other doctor.
I have a lot of different feelings about this story, but in the end I don't like the way my family doctor dealt with a case of anxiety.
I did see a psychiatrist after a few months, just for reference. And that went really well.
Yesssssssss!!! That was such a refreshing take!
Best lesson from this vid - Converse not Confront! Thanks Dr. E 💛
Honestly, I've found that medical (and, surprisingly, even some psychiatric) professionals simply don't take you seriously if you are diagnosed with any type of mental illness. I've experienced 10+ years of misdiagnosis and mismedication, with the only response from prescribers often just being to max out the dose instead of reevaluate. I've had staff in the ER yell at me to "wake up!" and snap their fingers and clap their hands in my face when I was experiencing a severe dissociative episode and couldn't remember my insurance information. When I was in the ER years later for severe pneumonia, the medical staff was too busy wanting to comment angrily on my SI scars instead of the fact that I couldn't breathe.
In any case, I really, really appreciate your channel, and I also appreciate Dr. Mike's as well. You both make me feel like there are actually kind, compassionate medical and psychiatric professionals out there - even though I can't say that I've met many of them myself. Thank you for taking the time to share your thoughts and knowledge with us. 🏳️🌈🏳️⚧️
A lot of my physicians think my symptoms are psychiatric, but every psychiatrist I've had has told me that my symptoms are not psychiatric. It's like when a lot of doctors and people around you pass off your symptoms as "just allergies", then one doctor chooses to actually do a thorough evaluation and they find the problem.
I had a nurse as my general practice medical provider over a decade ago (I'm in the USA, for ref) who was incredibly thorough and kind when I explained the brutal mental health issues i have during PMS and periods. She did a good overview history of my other mental health issues. My checkups with her always included a stress and mental health check in, very casual. The thing she said that i keep in my pocket was during a visit when she asked about my PTSD. I don't remember what i said, something to the effect of life is stressful but im taking it day to day. I felt dumb, that it had bever left me entirely.
"PTSD can't be cured. But it can be managed."
Every time life and my PTSD are a hard combo, i think about her, what she said, and review options for support and help. Her treating my mental health as equally important as things like my migraines or anemia or other issues broke down a lot of internal stigma for me, and it helps me look for GPs that see it as just a part of what i deal with.
Thanks for sitting in the heat for this one. Really interesting to see another doctors take on this, keep it up :)
A common bad experience I've had is when psychiatrists/therapists say "no thoughts about hurting yourself, correct?" It makes me feel bad if I did have thoughts about hurting myself, because I don't like correcting people, and it makes me less likely to be honest. I've also had a psychiatrist prescribe me medication without telling me, so I had to find out from my mom that I was taking a new med. That happened when I was 17. My worst experience was when I was having a very severe reaction to a medication, to the point where I couldn't eat, and would have bouts of severe nausea combined with uncontrollable anxiety, and my psychiatrist wouldn't admit that the reason I was so sick was because of a medication he gave me, he instead told me I had an eating disorder (because all teen girls who lose 10 pounds in 2 weeks have an eating disorder), and tried to send me to residential instead of helping me with my severe discontinuation syndrome from the med he gave me.
What I loved about my therapist is that she had the perfect balance of asking questions and being straight forward. Sometimes I'd overthink a small thing in our sessions and she would simply say "but that's ok, right?", "is that so wrong?" Or "you're fighting reality again" (my favorite, sounds better in Dutch though). It might not work for some, but it definitely worked for me. I once asked her how she does that, and she said that she adapts her communication style to the person she has in front of her. She admitted to being straight forward with me, but also said that some people cannot handle that and she uses a softer approach to them. I think, if I'd have to sum it up into 1 piece of advice: listen first, and communicate to your patients in a way they can understand you
I am treating depression, it started being pretty bad about 4 years ago.
About two years ago I finally felt that the meds were right, we increased the dose and so on, but the meds are the same drugs since then.
The problem: the same meds that made me not depressed and functional again also made me gain about 30 kg.
This weight gain made my "physical" health worse, so I had to go to a lot of other specialties to treat this new stuff.
Some doctors were great, they understood that I was not a unhealthy unconscious patient. They offered me options and tried to make the weight loss less hard and feasible without messing up the depression treatment.
But some lectured me just like I was someone that doesn't exercise and eat junk food all day because I am lazy.
Some brushed off the terrible depressive episode I had and never asked if I needed appetite enhancement to get better (I did). I wasn't eating, I wasn't showering, I wasn't getting out of my bed. Eat more became a huge improvement for me. Yes, I gained weight, but I stopped crying, started sleeping again, resumed my activities...obviously I wasn't focused on eating only vegetables and exercising.
I was berated as I had a character flaw, not a consequence of my poor mental health.
Some doctors simply look at weight gain as a problem of lack of willingness to cooperate, bad habits and so on.
I AM ON RECOVERY, it's bad now, but it was worse! I had a 50/50 experience with doctors...some were great, but some were very judgemental. The issue is that the negative ones are always what you remember most so it impacts us more than the good experiences.
I am a woman with multiple complex and rare medical conditions, and I have learned to never, ever discuss mental health with any providers - even my subspecialists. I go into medical encounters understanding and accepting that there will be some extra time required to explain and get everyone caught up with my medical weirdness because it is super weird, and most providers have never had a patient with any one of my laundry list of conditions. If there is even a whiff of anxiety, depression, etc. in my chart, it delays diagnosis and treatment by adding frontline hurdles of, "your symptoms are anxiety/silly woman histrionics (or whatever) and it's definitely not medical" and the burden is on me to be able to carefully inform the provider while not tweaking their egos. The amount of mental energy that takes - especially when I'm in urgent/emergent situations is monumental. This has literally put my life in true danger multiple times in emergency situations. "Your heart rate is high, and your voice is shaky, sweetie. Are you nervous? Just take some deep breaths and calm down." No, I am in anaphylaxis, and my vocal cords have swelling around them causing the shaky voice. I hate that I, and so many others, have to calculate the risk of addressing mental health, and getting physical medical care that could be delayed by scapegoating physical medical issues as mental health.
Good communication with my doctor (and consequently my grandma): I was going for my annual wellness appointment, and my PCP brought up my anxiety. I've been diagnosed with Generalized Anxiety Disorder and stopped going to therapy after my therapist moved hospitals. This appointment was also shortly after my father had undergone a procedure requiring anesthesia, and had yet to wake up from it a few days post-op. Of course, that caused my anxiety to run wild. My PCP brought up the thought of medication, to which I immediately agreed and explained to my grandma that meds had been on my mind for months, but I never felt comfortable bringing it up. My PCP promptly wrote me a script for Lexapro and scheduled a follow-up with a psychiatrist to see how the meds were helping. No shame, no stigma, only support.
Taking PCP brought up anxiety? Yup... Drugs are bad...
@@ankyfirePCP means “primary care physician”, not the illegal drug.
...PCP stands for Primary Care Provider...@@ankyfire
Worst communication regarding mental health...Granted this was 20 years ago, but my ex had me admitted for a 3 day hold for my psychosis. The nurse asked if I felt safe at home IN FRONT OF HIM. And I was NOT SAFE with him. Never was I asked again. I hope things have improved since my experience.
Best communication started with gaslighting by my primary. I felt depressed and exhausted. Primary blamed it all on my high BMI. He said I have sleep apnea, but my husband confirmed I don't snore. Antidepressants were prescribed and a sleep study referral. So I go to pulmonary for sleep study. I explain my symptoms to the Dr, never did he mention BMI and he actually suspected narcolepsy. During that appointment I was sobbing, sobbing because I felt like this Dr actually listened and absorbed my words. I didn't start the Antidepressants because you need a duration of sobriety for the MSLT. After my 2 sleep studies, confirmed narcolepsy. Went back to my primary to basically rub it in his face. Been on medications and drastic improvement of symptoms, and my life style will always account for some of the symptoms.
Look I know weight loss is important, I don't deny that, but when patients are confident something isn't right, Dr's have a duty to listen or admit that something is puzzling that needs further investigation.
I'm about to finish my bachelor of psychological sciences, and half way through my degree I was diagnosed with ADHD and ASD. Neither diagnosis was a shock to me. I digress, I went through 3-4 different psychologists before I connected with the one that really helped me. I'd had the WORST stomach issues for 3 weeks straight, and no doctor could work out what the problem was despite the tests and the scans. There was never an actual diagnosis or reason given, but it was likely a 3 week long severe depressive episode. I couldn't sleep in my own house, I spent three weeks on a friends couch because being at home had me in horrible panic attacks. The psychologists I saw before the one that helped had the attitude that because I was studying psychology and came across extremely introspective I didn't need to come back for another session. It's different when it's academic, or even looking at another person in case-work or real life than it is when you look internally, or at least it was for me. I know it's a medically "going out of date" model (or at least a lot of papers claim it to be), but the biopsychosocial model really explained all of my symptoms. My mind made me think I was actually going to die. It took one psychologist to tell me he wanted to have more sessions, and it really helped, finally having someone who let me unload the stress in my mind and quite frankly stomach and put it in as much context as possible.
I love your videos always and this one especially!! I'm a psychologist so i always feel related to the struggles with stigma, dismissing patients... i love your way of speaking and explaining, so clear, so spot on, and agree that mike's video was very good!! Happy to have reached to your channel. Homophobes be damned, you're an amazing force for good, psychiatrist with amazing videos about how homosexuality used to be treated and considered as a mental illness, you have the best position to talk about it and i love it!
The way you communicate criticism is just as important as what you're saying when trying to teach/correct someone. I know if I'm called out for doing something wrong, it can take all my mental strength to not shut down and disregard the other persons viewpoint.
If they come in hostile, mocking the mistake or belittling me, I'm likely to just get angry/embarrassed and dismiss them. It's an issue I have with my current manager, I'll deal with problems myself because she seems to enjoy pushing peoples mistakes in their faces so it's less complicated for me to get it wrong and correct my process myself (Although I'm in a much less stressful role in retail, not medicine).
Not mental health related, but wanted to just share some love for you and your content, it's been a fantastic experience and it's been a great learning tool.
Also saying you will look more juicy as the video progresses definitely raised the temperature 😂
I suffered for 30 years with psychosomatic illness. Primarily chronic pain and went from doctor to doctor doctor and I was dismissed over and over again. I was at my wits end. No doctor would help me. And I felt completely alienated and ashamed and lost. I am so relieved that there is finally more understanding around psychosomatic illness and chronic pain, and a wonderful community of people now who are there to help.
The pediatrician I used to go to used to work with my mom who’s a nurse practitioner in pediatric neurosurgery.
That being said the doctor I went to never did any work outside of the basics he has to do to ensure im safe enough to not contract any preventable diseases . He only ever consulted my mom on issues and she is… well… very stubborn and unless I’m passing out once every five hours it’s not considered a real health issues to her.
This lead to me getting called a hypochondriac by the doctor multiple times. To my face-
Everyday when I was seventeen I dealt with severe headaches and aura. It was written off as just stress immediately because my mother said so.
The moment I turned 18 I was able to switch to a doctor I didn’t know and FINALLY had someone look into my issues. The last straw with the headache issue was actually when I had a faux sort of seizure. It turned out I have severe chronic migraines that are genetic.If you don’t take multiple factors into account and issue might be so overlooked it gets pushed to the breaking point. 😭
Your channel is such a cooling fresh breeze of air. Love your content and way of explaining things for all of your audience. It really feels like a safe space to learn and have fun. Keep doing this amazing work
and pls watch more hannibal soon :>>>
My regular psychiatrist is very good at explaining things to me,, and working with me. I'll take last week. I was having a breakdown due to a number of stressors, causing unsafe thoughts. He explained he wasn't comfortable with me staying at home and felt I needed to be in hospital. He was concerned for my saftey. He gave me options for how this would happen, and then wanted to speak to my parent(this was virtual). Now this wasn't my favorite interaction, as I did not want to go to hospital, but he handled it well and I went. I appreciate that he felt concerned and took action.
Now while I was in the hospital, something that really bothered me that THEY did not handle well, was diagnose me with a new mental illness, BPD, and not even tell me. I had to find out on my discharge paperwork. They also discharged me after 1 day, when I was clearly not ready or safe to be discharged, but they basically convinced me I was.
I can definately see why people may have misunderstood and been upset by his statement. I have had many health issues over the years and because I have a diagnosis of bipolar disorder it's often the first thing that doctors jump to, not the last, often before they even do a physical exam or blood tests. And then when I get upset at not being listened to, it seems to confirm it for them, even when it's unrelated.
Last year I suddenly had a period where I was so incredibly fatigued that I couldn't work, couldn't look after myself and needed to sleep a lot. This of course impacted my mental health quite badly which probably didn't help. I went to the doctor who suggested I was stressed (yes stressed because I was ill), should lose some weight (put on because of months of this illness) and should exercise more (cruel advise for someone who is struggling to even dress themselves). When I tried to explain that the extreme fatigue was unlike anything I'd ever experienced with depression, she just shrugged and I went away with nothing other than her teriible advice. After months of struggling, a short course of antibiotics for an acute infection fixed me pretty much over night. It was a horrible experience and I now get incredible anxiety whenever I have to see a doctor.
I was experiencing severe depression for many months with severe fatigue and heart palpitations, barely able to sit up straight or walk to the bathroom. It took a long time to realize I had POTS, but even still, I think the depression played a big role too. It's likely that the fatigue from the depression caused me to spend a lot of time lying in bed, which exacerbated the POTS. And the heart palpitations from the POTS made it even harder to get out of bed or think clearly, all of which was very depressing.
I also have some mystery neurological issues like balance issues, stuttering, and muscle spasms. I got a neurology workup which was normal. But I still remember when my psychiatrist texted me suggesting that my symptoms might be psychosomatic manifestations of the depression. I was offended; I was thinking, "How dare he?!?" I do think that speaks to the huge stigma behind psychosomatic illnesses and symptoms; it can feel like an insult for that to even be suggested. But really, it's just a medical issue like any other.
Dr. Mike's communication is an order of magnitude better than any discussion I have ever had about brain health with any internal medicine or general physician.
I have ideopathic angioedema all my life. Presented at 16 with hives diagnosed as the result of stress. No treatment, tests or followup suggested. I was diagnosed two decades later.
Conversely, my long-term major depression was not diagnosed until I was 40. Recently, my internal medicine specialist handed me a depression scale to fill out, as she is aware I have major depression. The scale indicated I was having suicidal thoughts. The doctor asked me if I had a plan. I did. She told me my depression scale score was lower than last time, "so that was good." That plan was so delicious I spent the next few days staying at home reminding myself that my therapist said if I hung on I would likely feel better.
Overall, it has not gone well with genderal medicine/internal medicine/hospitalist people.
TW: weight and eating disorders
I have far too many examples of terrible communication from doctors, the most recent being from a few months ago. I was in for a concern that yes, could have been influenced by weight and therefore that was an appropriate conversation to have. For context, due to the pandemic, this was only the second time she had seen me in the past 3 years.
Dr: “so I can see that you’ve put on a lot of weight”
Me: “actually, at my last weigh in at the endocrinologist, I was down 30 pounds, since the start of the pandemic.”
Dr: “but what is it NOW?”
Me: *stunned silence*
So now to figure out what to do about my primary care doc, in a location where it’s extremely difficult to find doctors accepting patients, and with chronic illnesses that mean I can’t be without one, and a relationship with the Dr that has been so damaged, I don’t see how I can trust her. And add on how to address it with the clinic, as one of the Patient Advisors on the Patient and Family Advisory Council. And topping it all, addressing the exacerbation of eating disorder behaviours, since this just totally reinforced the “no matter what I do, it’s never good enough” story that heavily underlies it all. So incredibly grateful to have a wonderful therapist I trust, before this all happened.
All to say, doctors REALLY need lessons in how to effectively communicate with their patients, in a way that protects the safety & trust of the relationship, without ignoring important health factors.
Oh boy, I could write an entire essay about my worst experience with a psychiatrist, but I'll try and keep it short. I had just finished my second year of university and was completely burnt out with (then undiagnosed) ADHD, which made me just so tired and depressed. After an hour appointment I was diagnosed with a personality disorder at age 20, got told I couldn't possibly have ADHD because I was 'at a good university' (despite there being a clear pattern of underperformance at school including me retaking year 12), put on anti-psychotics, and swiftly discharged from the CMHT. Once I'd received my notes, the psychiatrist had described me as an 'overweight female', despite me telling him about my issues with binge eating at the time, which honestly felt like an unnecessary observation due to my weight and BMI being on the NHS system. There were also several mistakes and just blatant lies within the notes which were used to justify this diagnosis. These anti-psychotics made me too anxious to leave my house - I had no idea that this could be a side effect - due to the side effects I was almost sectioned and had to drop out of my year abroad. Once back under his care, I continually tried to fight the diagnosis because I felt like it didn't fit what I was experiencing and get a referral to an ADHD assessor, to which I got continually told that I did not have ADHD and instead was put on medication after medication without much explanation.
My best experience is with my current psychiatrist (I immediately requested to be referred to the CMHT at my university city once I moved back!). During my first appointment he actually listened to me, agreed that an ADHD assessment would be beneficial 'even if it rules it out', and thought that the EUPD diagnosis doesn't seem quite right. (I have had the ADHD assessment, I do in fact have combined type ADHD, with 9/9 and 6/9 of the symptoms...). Every medical decision made feels like a joint one, and he always takes my opinion into consideration. I think the main difference between my worst and best experiences, is that with my current psychiatrist I am treated like an adult with insight into my own brain/thoughts/emotions which didn't happen before.
Apologies this did turn into an essay, but I hope it makes sense and is helpful! I love your videos :)
Great video! I was thinking a lot about the possible biases that are associated with overspecialization and started to wonder how much do you know about the biological components underlying mental illness? For example, I have suffered from agorophobia and tried therapy for a long time. I never found a real social or environmental reason for it. It was like it was just present in my brain out of the sudden. As a patient it definetely felt like something biological or genetic. Fortunately it simply improved with time.
Thank you so much Doc, this conversation needed your input! I'm a law student studying 2 complementary majors, unfortunately the fraternities are competitive to each other so I'm witnessing professional tribalism too. It's a horrible waste of resources and deprives us from reaching to the most fruitful result. Has dr. Mike made mistake in the past? Yes. But this is just stupid. A good professional knows when to differentiate between a big picture approach and a detail oriented approach. Nothing lives in isolation, we live an ecosystem. It's commonsense to me how mind-body-soul are be interlinked. Hopefully other docs will learn this too.
It helps me to have separate and specific diagnoses because over time, I've gotten better at identifying which symptoms belong to what (Bipolar 2, BPD, CPTSD) and which might be overlapping. It can definitely be challenging because I've been dealing with trauma hardwiring the majority of my life.
Done badly:
I used to have a GP I was stuck with due to a terrible shortage we had for a few years. I had treatment-resistant depression and OCD, and sat in his office for maybe the fourth time that year with the same complaints I always had. He said “*name*, you are on medication, you see a counsellor. Why aren’t you getting better?” He said it with frustration, like I wasn’t trying hard enough to get better.
Lol the orthopedic doctor reminded me of the time I tore my rotator cuff...and was also super depressed 🤣
I have emetophobia and I used to have a range of psychosomatic GI symptoms and regular panic attacks. When it first got really bad I went to see my former GP about it because I was worried that there might be something seriously wrong with my stomach and was told to just take MCP and wait it out. I then noticed that it only got worse and I was getting anxious about getting nauseous when I don't take the medication anymore (I also didn't want to depend on metoclopramide) and I started to suspect that my nausea and the extreme anxiety accompanying it may be even more connected than I thought. Tried to bring it up to my old GP who didn't listen so I went to a different doctor who's still my current GP to this day. He took his time, listened to me, ran some tests to rule out physical causes of my symptoms and said that he also believed my symptoms were psychosomatic. Maybe it was because I myself believed that too but I felt validated - it also helped that he came to that conclusion after careful consideration and still took his time to rule out the most important physical causes. Either way I felt relieved and not dismissed. My symptoms actually improved a great deal after that but he also recommended a therapist who also helped me a great deal. I still have emetophobia but I haven't had a panic attack in ages and I can live my life pretty normally now.
That same doctor then also proceeded to help me with some other stuff that would take too long to explain a few years later and it's because of his help (and my family's support) that I got my shit together and passed an important exam this year and can finally start my final year of med school.
Doctors should refrain from using the mental health card until they have exhausted possibilities and referred the patient to all relevant specialists, many of them use the issue of mental health to justify that they don't know what the patient has. I was recently diagnosed with a rare form of autoimmune vasculitis, have had nonspecific symptoms all my life and have been referred to psychologists and psychiatrists several times; recently the disease started to show clear signs in my lungs, and the pulmonologist (a very important specialist in my country) gave me a (wrong) diagnosis and treatment, and when I told him that I was feeling worse and worse he replied that there was no physical cause and suggested me to attend psychological and occupational therapy... this, besides making me feel terrible, delayed my diagnosis and allowed the disease to progress. This is why I understand why people and other doctors are upset with Dr. Mike.
I think what Dr. Mike is trying to say here is that your mental health affects your physical health and your physical health can affect your mental health.
When I asked my GP for antidepressants his first question was "Why are you depressed anyway? Were you abused as a child?"
I have ADD and high functioning autism, I also grew up in a broken home with a negligent mother, so I have a lot of issues and have been in and out of therapy most of my life.
Best communication I ever had with a therapist was one that actually listened and engaged with what I said, gently direct the conversation towards specific issues, and helped me work through those problems in a constructive manner.
The worst communication I had was with a therapist that practiced a specialized neural scan and in our sessions they never did anything to direct the conversation or tackle any of my issues, it was less like therapy and more like chatting with a friend at the pub. The only thing he consistently tried to do was sell 17 year old me on getting this neural scan. I wasn’t fully equipped to handle the situation yet I knew I didn’t need that scan. What I really needed (and still do) was someone to go through all of my issues with me, help me work through the damage, prescribe medication where needed, and advise necessary changes to my lifestyle and support network to improve my quality of life.
Dr. Mike Very Very Good D.O. !
DR. Elliott Your More Speicalized In Mental Issues!
I'm A Fan Of Both You Guys Vlogs !🙆♀️😱🥰🖥
I have been confronted about my mental health and I had conversations about my mental health. Also, I have invoked conversations and confrontations about the mental health of my dearest and closest people. I think it boils down to whether one can convey true concern about someone (be empathetic), or one just wants to cause harm or take revenge. "Therapy Speak" is being weaponised too much these days, so I try not to fall back on it when trying to help others. However, when used against me, it did bring me to educate myself as much as possible and seek actual help that I was fortunate enough to receive. Please don't fall back on anger when confronted, you wouldn't if someone saw a suspicious rash on your back neither :) .
Good mental health communication story: I was in hospital with chest pain. I’d had depression and anxiety for the past 8 years or so, was on meds for it. I was terrified that if I was having a heart issue or something it would get written off as “just” anxiety as soon as they saw my history and my pain would be dismissed. But when the doc asked if I thought it was anxiety related and I told him no and explained why I thought that, he actually LISTENED. I cannot explain how much relief I felt that he was actually going to listen to me, take what I said into account, and carry out more tests etc. Tuned out it was indeed an anatomical issue, luckily not very serious, and my faith that there are good doctors was restored!
Great video docmike 🥰🥰🥰
I have IBS and have been prescribed antidepressants for it twice… It sucks. My depression is a result of the IBS, not the other way around. I hate not being listened to by my doctor. I’ve pretty much given up on getting help for my IBS.
Hey Dr Elliott, big fan. Just because I cannot grasp what you mean, when you are talking about the "trauma" part, do you mean that there was already an underlying disease/disorder and that the trauma caused it to "wake up"? Or did you mean something else? Great video as always!
When people are confused about what holistic medicine is, I think you said it best, "health care is a team sport"
I think my worst experiences with psychiatry have to do with pill pushers. I had a psychiatrist for 10 years who was recklessly prescribing me combos of uppers and downers. It wasn't until I had a major suicide attempt, and an in-hospital psychiatrist looked over my medication list, that it was brought to my attention that it was dangerous. My current doctor is extremely cautious with changing things and has been a big champion of therapy before tinkering with meds.
I have Ankylosing spondylitis, endometriosis, and inflamatory disease of the colon, and YES the simptoms are really affected by my depression and anxity.
Here in Argentina we have free healthcare, and in my hospital I have a team of teams of different specialists, including of course psiquiatry and psicology, they all work together and comunicate between them.
I have functional nuerological disorder and postural orthostatic tachycardia syndrome. I have been through doctor after doctor. The majority of them would run no tests but tell me it was all in my head and/or I was faking. My current group of doctors ran everything, and then came to fnd and pots. When my neurologist discussed this with me he made sure to tell my mom and I that I wasn’t faking, this is real, and that the neurons in my brain just aren’t sending signals correctly. Probably due bc of my ptsd. He also said that trauma is not the only cause of this and sometimes it just happens. The pots he said that it wasn’t anxiety causing these symptoms but that it’s my body just doing it. I’m so incredibly grateful to my team of doctors now, but I still get extremely anxious and cry whenever I have to go see a new doctor bc of how the majority of doctors have treated me. There is also a huge stigma around fnd and I have 100% been treated worse by new health professionals bc of it. I feel like my team of doctors are a lot like Dr mike in their thinking. I do however understand why people would be upset about what he said bc with most doctors I would be to. It’s that he said after you do all the tests then you have that conversation that made me appreciate what he said.
Great analysis. I wish more people took time to process what people say and do some basic level research before just spitting out potentially harmful nonsense. I personally just can relate to all of this because I experienced this. My mom has scoliosis but she used to always be in pain despite surgery and other treatments. But once she worked on her emotions and her constant anger towards her parents for neglecting her, that she suddenly felt relief from her pain. She broke down and she worked every day on herself and she never blames any of her past doctors or the chiropractor that tweaked her neck so bad she was on oxygen and thought she was going to die. She did not sued him but he stooped practicing. Mental health and Physical health and energy are all important steps to working to improve yourself. It can be scary and intimidating but I have seen how beneficial it can be for peoples health over all. Mind over matter or matter of mind, it is always a choice.
I had a period where I started having breathing problems a few weeks ago. I do tend to have allergies in the late summer. I went golfing, which can make my lungs feel like 💩 because of all the pesticides, but then I started to notice breathing difficulties and eventually my throat closed. I went to see the doctor and I felt unsure whether these symptoms were “real” or anxiety induced. Although we never reached a conclusion, he did prescribe me an inhaler just in case. It felt very real, it felt like I had to force my airways open, and I could only do it for a few seconds at a time. I’m so glad to see that these symptoms are “valid.” It feels like I am constantly worrying about whether my symptoms are physical or anxiety induced.
10:12 Well dr mike did say once in freaky eaters that you cant start of with a confrontational nature right away
I have depression and any time I go through a low mood episode the differences between the responses of my GP and my therapist are startling. GP interrogates my sleep, eating, exercise habits in a manner that leaves me feeling like my depression is my fault and exacerbating my feelings of shame and amplifying my low mood. My therapist responds with empathy stating how depression is a self-perpetuating cycle because the things that would alleviate the symptoms of low mood (sleep, exercise, socialization, etc.) are the the things that depression targets. Both professionals having the same diagnosis and the same advice, but with vastly different approaches that have had completely different effects on me.
I had a Doctor say I was trying to "score" benzos, despite my diagnosed mental illness and my medical history of not abusing that medication. I managed to keep it together until I was out of the clinic but boy did it piss me off.
Calls out tribalism in the beginning but comes for the cardiologists at 8:10 lol. Great vids from you guys lately keep it up!
I think the most important thing to me is the manner your doctor has. This year I started experiencing unexplained musculoskeletal issues, that later developed into intermittent, symmetrical flare ups over the past 9 months. I was found to have low vitamin D, and I really appreciated that my GP approached me from the perspective of, "honestly, there's not really that much research into the full symptoms of vitamin deficiencies, but vitamin D deficiency has been known to cause bone aches. That's all we've found in your bloods so far, but we'll have a follow up to see if supplements address the issues."
Supplements cleared all the symptoms I had attributed to mental stress over the musculoskeletal issues (sleep, mood, fatigue, dry skin), but I still have said musculoskeletal issues after 5 months. I'm not nearly as stressed about the lack of explanation for them though because of how honest my GP's approach was. I wasn't told "here, this will fix it", the door was left open to explore other avenues if this potential explanation doesn't resolve it. It also wasn't default attributed to my existing conditions, even after discussing them with the first doctor I saw.
I just have to hope the different GP I'm seeing in my follow-up is willing to look into other causes. If the 'full' blood tests they did twice are clear, my hormones are good and my RA factor is negative, I’m worried they might not test further because of how many women I know whose symptoms remain unaddressed because basic tests don’t explain them. I'm feeling cautiously optimistic though because I'm fortunate to live in a more affluent area, and I absolutely believe UK GP services can be like a postcode lottery in terms of quality of service.
We should always listen to our bodies. I was in a relationship that was turning toxic. I knew in my mind I had to break up with this person. But I was afraid he would get violent so I just stayed with him.
Then I had INTENSE pain down the back of my leg. Crippling pain. I thought it was my sciatic nerve.
Then we broke up and my pain was just gone. I'm convinced my body was giving me the message that my mind wasn't hearing.
I will always listen to my body now if I'm having mental health challenges.
Lol I had a GP in the UK try to diagnose me with health anxiety instead of allergies and say it was psychosomatic, when my lips were the size of a balloon… Till I pointed out I’m a psychologist studying counselling…
10 years ago i went thru mental and physical breakdown. It was most likely trauma related as it started 6 months after breaking off from abusive relationship.
The manifestation was very physical. Started with herpes zoster and continued with low immunity issues like constant infections, eczema, yeast etc. I was feeling extremely sick couldn't walk up the stairs.
I went in and did any possible blod test or examination. Everything came out fine. I really suffering but none of the doctors i have seen were looking beyond the blood work. Noone suggested any calming medication or even asked how i was feeling mentally. I could feel them looking at me like you would at crazy person. Half of my face was feeling numb and i had a double vision in one eye yet they were telling me im healthy. I was on my own in a foreign country i was seeing therapist back then but i was so far gone that talking therapy couldn't help.
That was hell. Only after 6 months i met a masseur who suggest i go back and ask for a relaxant. So i did and ended up takind valium for a week. Which was enough for me to get balance and start making changes.
It was in Central European country. Im mad too this day that all the doctors i have seen ignored .y suffering just because my tests were ok
Oh i have one! When i was 8 months pregnant with my first child, my mom died and i was a mess. I wanted to consult my obgyn if its safe to take anti anxiety meds. I mentioned being extremely anxious and depressed but i did it while smiling and appearing happy. He just shrugged and said you look fine to me and that was that.
Truly you have the best take I’ve heard. The brain is still part of the body & infact it’s the control center of the body. It’s wild that the majority of the medical field views mental health as pseudoscience.
One of my worst was when I lost my health insurance and was forced to go to a new doctor for my ADHD medication. Even though I had been diagnosed for years by my family doctor, he insisted that I get a diagnosis from a therapist before he prescribed anything. So I went to the practice he recommended and set up and appointment as soon as I could - three months away. Then I go and it turns out that the person they had me speak with and describe my symptoms to was only a councilor and couldn’t prescribe meds. I couldn’t even talk to the therapist until after that councilor, which was a huge waste of time and money. To set up an appointment with the therapist was going to be another six months out. The whole thing was hell and I just gave up on my mental health for years.
The best is my current doctor. When I told her I have ADHD she didn’t even question it, and she’s been amazing at working with my on figuring out my correct dosage. When I lost my health insurance again she set up over the phone appointments so she could continue to prescribe me my medication without costing me more than I can afford. She’s genuinely one of the best experiences I’ve had with medical professionals in my life.
My worst experience (MH related but doctor was a GP) was when I relapsed pretty severely with anore*** (I have a history of 13 years in total with thar illness and am now 4 years in remission so I know what a relapse looks like) and pretty early on at the insistence of my friend I went to see a doctor to tell her I was struggling again and where I could go to seek help. I had moved for uni so this was a new city. I was quite proud of myself for getting myself in so early, but the doctor just said "you don't look anorex** yet though. We can do blood work if you insist..." best believe I didn't ask any doctor for help again for another couple of months - because months later I was in the emergency room couple times a week and had lost a considerable amount of weight. Two years later I started my masters in prevention and Healthcare management (that's a mouthful I know) and we learned that no matter what any treatment outcome was significantly improved by the doctor/caretaker BELIEVING their patient. Doesn't matter if their suffering is visible, measurable, etc. It's real TO THEM. Made me think of that doctor and how much they didn't do that. Also I would like to add that I know Eds have no look, but she obviously didn't. And that was in that moment incredibly, incredibly harmful.
My best encounter was actually getting diagnosed with BPD. It was kind of a group effort of my Psychiatrist, therapist and then my psychiatrist inpatient, but they were all lovely and really told me over and over to focus on symptoms together and to not put the focus on the label. I actually have no problem with the label, but it was a good approach bc you can't work on a label you can only work on the parts that make up that label. Felt really well taken care of by all the physicians involved in that process.
this video is a great comparison to Dr. Mike's vid. there so much conversation that needs to be had about mental health care. I'm in a weird position where my GP is actually quite educated and observant in terms of mental health, yet the cmht is really bad. Really bad. They're more likely to take the dismissive, "it's all in your head" approach and look to write you off as you're being overdramatic or making excuses, and they're generally rather unempathetic. It always feels like you have to try convince them that what you're experiencing is real and daily and that you really do need help; if you can't, they won't help.
A close friend of mine is diagnosed with PTSD. For about 3 years he had suffered from a lot of problems with eating and vomiting and got really thin and weak, every time he went to doctors they just said its episodes of PTSD and panic attack... turns out he had a bactiria infection for years and this was not the PTSD....
Another friend of mine had suffered from headaches going from doctor to doctor and being desmissed for anxiety, and being transgender being told its hormonal or just stress. He volunteered for an mri research (unrelated to the pain) and was sent immidiatly to the emergency room it turns out that he has a rare genetical dissorder of the bones that causes the his skull to "grow" and cause a lot of pressure on the brain. This could have been seen in a simple CT scan that none of the doctors he went to thought to do, because they rulled it out as anxiety...
Sometimes all doctor can see is mental illness 😔
I recently had my gestational diabetes test. It was perfect. But what was interesting to observe in my medical history (and what we didn't previously know) was that back when I had my last bloods checked in April last year, apparently my HbA1c were at prediabetic levels. Obviously not a problem in the end because the numbers had clearly settled, but it was a small quandary. I am generally a healthy eater, at a healthy weight, and physically active. But then we thought about it and the only thing different about that period of time a year and a half ago was that I was going through and INCREDIBLY STRESSFUL time in my life, and had been on one level or another very stressed for the 8 months previous to that. My life has since evened out and calmed down, but we think that my chronic stress and mental state on the level I was experiencing it caused a physiological response in my body which has thankfully gone back to normal.
I don't know how it is in the UK, but in the US people with disabilities are very much seen as lesser humans by the systems in place, not just in health care but in other aspects. Any time a conversation is to be had about mental health and how much is can not just affect someone, but disable them in certain ways, there is always a vehement push back. Not particularly because of the stigma around mental health (though that is certainly a factor), but because, subconsciously or consciously, we are innately aware of how disabled people are treated in this country and don't want to risk being treated as horribly as they are. So instead of having the nuanced conversation of "mental health can be debilitating," we (the general populous) would rather just not talk about mental health at all. (The connection between mental health and disabilities is that the government has tried to (and sometimes does) pass laws that increases what qualifies legal as being disabled, not to help more people get the help they need, but to systematically continued to oppress them. It's incredibly nuanced and a deeper explanation is often talked about by Imani Barbarin.)
I feel as if short form content is fantastic for getting more awareness of a wider range of topics out to the public, however the serious time constraint can lead to a lot of oversimplification.
I think that when we have a lot of expertise in a specific field, we may lose awareness of the need to explain things and their basic foundations in such a way, and to such detail that the general public can fully understand and not misinterpret what we are putting across.
I'm a person with mental health disorders and related physical problems. The way Dr. Mike explained it sounded pretty accurate and clear given how short it was, without much opportunity to delve into nuances. I've dealt with medical providers' dismissiveness on the issue, which IS a really common and frustrating thing, but he didn't sound dismissive to me.