Not thinking before you speak

Greetings all,

I begin this post by declaring that I know that in Australia we are fortunate to have the right to free speech. In particular, I am referring to Mr Mark Latham’s article published in The Financial Review last week which has caused an outrage amongst women who have mental illness or care about those who do. But what I struggle with is when those who speak from a position of influence don’t think before they speak. Or if they do and they are found to be incorrect, or indeed cause harm, don’t apologise.

I have no legal training and I am not a journalist, and don’t claim to know about tactics to sell papers or how a person is chosen to contribute to content. I am however a psychiatrist who can spend up to half her time in initial sessions with some patients reassuring them about what I can offer them and why it is a sensible and medically advised decision to seek help for mental illness. It is why I wrote my book “How Shrinks Think”. It’s where I see the most stigma. Behind closed doors, people suffering that I know we can help, but those that would be horrified if their friends or colleagues knew they were seeing a psychiatrist. Those I see get better, sometimes with medication, and still don’t want anybody to know they have a mental illness.

I can’t comprehend why Mr Latham would comment about mothers and mental illness, especially during BeyondBlue's post natal depression awareness week (16-22 November 2014). I do consider it necessary to set the record straight regarding depression and motherhood from a psychiatrist’s point of view.

If a woman is biologically predisposed to developing a mental illness they are more likely to have an episode at the time of hormonal fluctuations, i.e. during puberty, at the time of menopause, and guess what, while pregnant and after childbirth. Hence why the subspecialty of perinatal psychiatry exists. Hence the scrutiny for the emergence of post natal depression in biologically vulnerable people to protect the mother and in extreme cases the baby. See the logic there Mr Latham? The baby doesn’t force the mother onto antidepressants, the mother isn’t weak but the mother may be biologically predisposed to the development of depression, with episodes triggered by these hormonal fluctuations. Fantastic, capable, loving mothers who also have a personal or family history of depression. Thank goodness we do have effective treatments, dedicated mother‑ baby inpatient and outpatient services that care for both mother and baby while keeping them together to encourage bonding. 

Guess what else, Mr Latham, we know that we need to help the mother for the infant’s well-being as well. Something the child will not be blamed for, but the child may thank the mother for.

I have heard the notion that antidepressants are a band aid, a happy pill, something to become reliant upon or change people’s personality so many times it’s really not funny. No endocrinologist would cop the same when prescribing insulin to a 4 year old child who has type 1 diabetes. If a mother has depression she should not be made to feel ashamed if she needs to take antidepressants.

So I do concede Mr Latham has a right to freedom of speech but I would prefer it be informed and evidence based. I ask the Financial Review to accept utmost responsibility for publishing these remarks, pointed towards a successful and happy mother, by retracting the article. Remarks similar to those Mr Latham has made in the past regarding patients with mental illness. Then I can carry on working to debunk myths, educate and above all help my patients as my profession would want me to do. 

Finishing my book then having a good lie down – on the couch

Greetings all,

Well, I am very happy to say I wrote the final words of my new book “How Shrinks Think” yesterday (editors changes pending). The last word I wrote was ‘psychiatry’. The last topic I wrote about was psychiatry and social media. Who would have thought that this Facebook avoidee and Twitter ignorant person a year ago would now be embracing this great means of global communication!

It is timely for me to reflect on this change in my learning and outlook. That’s because I don’t think I would have ever finished my book (editors changes pending) if I didn’t receive all the help, support, encouragement and opportunity I have been fortunate to experience in the Twitterverse this year.

Some of my friends and colleagues in my life know I have been writing a book since August 2013. Many don’t. It does feel embarrassing I suppose to announce where ever you go that you will be an author someday. So, in the main I didn’t. But on the rare occasion that I did, people seemed generally interested. They were interested to know what I had written about and incredulous that I could be relatively easy in this era of self-publishing. But largely, I have written the book just for me. I don’t know how it’s going to be received, but regardless, I will continue to remember that.

In all sorts of ways the interrelationship between my experiences on social media and my writing journey have been closer than I would have imagined. I began to ‘play’ with the concept of writing about modern day psychiatry from the ‘inside’ on January 1 2014. I started my blog “How Shrinks Think” to sort out my own thoughts as well as gauge others impressions of what I had to say. I was scary at first but then a whole lot of fun. Then I gained the courage to use my voice as blogger and writer of “How Shrinks Think” in order to enter the world of campaign building. I was very involved in @AHPRAaction in May, and then wrote about the federal government proposed Medicare Co-payment and the effect it would have on those with severe mental illness. This propelled me into re-connecting with colleagues from the past, particularly from my AMA days, including Mukesh Haikerwal, and Amit Vohra. Opportunities arose from this including the privilege of being a speaker at the inaugural AMA(Vic) DiT conference.

I also discovered the talent and experience other doctors in Australia had when it came to writing. Although we have never met face to face, I consider Edwin Kruys in Queensland and Jacquie Garton-Smith in Western Australia to have really inspired me to keep writing and ultimately ending the journey that is the first draft of a book. I was fortunate enough to have some blog posts picked up by Croakey, and managed to connect with psychiatrists in Australia and around the world.

It is no coincidence that I will launch my book at @SoMebythesea on November 15^th 2014. I am organising this workshop amongst incredible people, many  I would never have met were it not for Twitter. It is amazing that virtually all of the organisation and promotion for @SoMebythesea has occurred via the amazing network opportunities of social media. Now I have Dionne Kasian-Lew, Marie Bismark, Mary Freer and Jen Morris coming along to speak at @Somebythesea. All people I have met via networking.

Of course, I have not forgotten my friends from the beginning and pre SoMe. Some are also growing and expanding their social media presence, like the sleep guru David Cunnington. Brad Mckay has been a great mate all along and a wonderful mentor for me in this new foray. My journey did begin with Andrew Griffiths and Kylie Bartlett, and I will always be grateful for their teachings and guidance. And all my friends who have been there, offering advice and encouragement.

So, the next 6 weeks are now in the hands of my editor, Roy Mazucco, and designer, Carly Goodwin. Incredible to believe but if all goes to plan, I will have my book in my hand in 6 weeks. May need to see a psychiatrist to process it all.