What Can We Do? Psychiatrist Shortage Increasing...

‼️ 911 ‼️

The psychiatrist shortage is drastically increasing. THIS IS A MENTAL HEALTH CRISIS!  The demand for treatment continues to grow, while the amount of available professionals continues to decrease. I am afraid. You should be afraid.  What can we do?

I think about this regularly, being not only a mental health professional but an empath; however, this week it really pulled at my heart strings.  I had a patient that was so symptomatic - in tears and could barely breathe. We utilized the ENTIRE session to go down the provider list on her insurance website and via google searches ... one by one ... one by one ... in attempts to schedule her an appointment with a psychiatrist!

“Ma’am, we don’t accept that insurance.” (Despite being on the provider list)

“He isn’t accepting new patients.”

“This call cannot be completed as dialed.”

“This number is no longer in service.”

“She will have to see one of our therapists first (discontinuing treatment with ME, her therapist that she is comfortable with and has already built a rapport with) and then won’t be able to get into the psychiatrist for approx. 4 months.”

What in the F@!$!!!

She was panicking. I was growing increasingly angry!

We even called her PCP for a referral. Nothing... they don’t have someone they refer to and don’t have a psychiatrist on staff.  BUT, the staff member DID agree that she should see a psychiatrist moving forward for psychotropic medications, as opposed to the ones their office is currently prescribing.

Plan C... What about the ER? Undesirable... patient can contract for safety... but what option are we left with?  We discussed how they could maybe get her some short-acting medication to temporarily calm the symptoms, while also scheduling her with an outpatient appt with a psychiatrist faster than she would be able to independently, or even with my assistance for that matter.  Contacted multiple ERs...

“We don’t have a psych unit.”

“This is how it works... she wouldn’t necessarily see a psychiatrist or get meds... they would just determine whether or not she needed to be sent to inpatient.”

“Sorry, there is nothing that we can do.”

Again, What in the F@!$!!!

This. Is. A. Crisis. A CRISIS!  I am beyond frustrated and terrified for what the future looks like pertaining to the field of mental health.

What can we do!?

Some of my thoughts - whether feasible or not:

-Psychiatrists need to speak on their craft.  Talk to children, inspire them. Go to college campuses. Work with med students to get them interested in this field of medicine.  Anything.

-Loan forgiveness/incentives:  any college debt/student loan is daunting... let alone med school ... help people afford the schooling so that they can enter this field!

-Fast track programs:  mental health professionals are (or should be) up to speed on psychotropics, forms of treatment, symptoms and diagnostic criteria for disorders, etc. [[not all, depending on their position, but hopefully the majority]].  Why not provide a “fast track” program for those that might be interested in becoming a psychiatrist?  As opposed to someone like myself that thinks ‘I already have 3 degrees... student debt... AND I am now going to essentially start at square one to knock out pre-med classes, do the whole med school route, residency...’ I know there are essentials that need to be met to obtain an MD, but again, maybe just finding a way to offer different formatting for those that already have a strong knowledge base in the field and can’t physically/financially restart their entire educational background.

I am not saying these are the answers. These are just a few thoughts that have popped into my head. What I am saying, though, is that we NEED answers!

Please share this - Please leave me your suggestions - Please speak about this, often, to anyone you can!

#911 #mentalhealthcrisis #psychiatry #psychiatrists #whatcanwedo #afraid #help #thisisnotokay #mentalhealthmatters #mentalhealthisphysicalhealth #socialwork #therapy #mentalhealthprofessionals #advocacy

The Horror of Being a Woman

When I was a child, horror movies were my ABSOLUTE favorite! I remember being in 4th grade, having a sleepover for my birthday, and forcing everyone to watch the Exorcist. Naturally, they were mortified. I was living my best life! The scarier, the better. To that point, though, I have never actually been afraid of a movie in my entire life. That was probably because I never truly absorbed what was going on in these films; meaning, I was young and the scenarios I was watching, the portrayed fears, or the underlying themes did not resonate at that time in my life.

Now that I am an adult, I cannot tell you the last true horror movie that I watched. Get Out, maybe? Is that even technically classified as horror? Anyway… I can probably blame that on my husband. We have been together since I was 21 years old and he has always vehemently refused to watch scary movies. It has irritated me, but I am starting to realize that it might have been for the best!

As we grow and develop, our impulsivity decreases (well, for most of us that is) and our sense of reason heightens. We are able to recognize good vs bad, moral vs immoral, risky vs protective, etc. Essentially, we are able to think things through! This change in cognition - along with lack of exposure over recent years - can be applied to how my thoughts pertaining to scary movies have shifted. When I was a child, the majority of the scenes did not have any relation to me or my life. The idea of a demonic presence did not make me ponder what that would really look like. Strangers psychologically and physically tormenting individuals in the middle of nowhere was not something I worried about (and I even spent my entire life going up north to a cottage on a secluded lane in Cheboygan, Michigan!) Someone dismembering and eating human body parts… disgusting… but that was just a shock and awe factor in a film. All in all, the gravity of the situations that these movies were showing me never really impacted me as they would today.

Today, I have life experience. Today, I cry at the drop of a hat. Today, I have to refrain from watching the news because my heart breaks into a million pieces over, and over, and over, and over… Today, I have real empathy. Today, when I see trailers for most scary movies, I get disturbed. Some still appear thrilling and I get the itch, begging my husband, “Come onnnnn! Let’s go seeee that one!! Pleaseeeeeeee…” But I had a situation occur today that made me realize exactly why I stay away from the majority of things that do not make me feel positive, healthy, or happy. Obviously, there are some bad things that we cannot avoid or just simply must endure. But I have really been trying to be conscious of refusing to engage in media, activities, relationships, etc. that make me feel uncomfortable, disappointed, confused, or depressed. Again, not always possible… but when it is… I choose filling my life with joy.

I broke that rule today. I let myself down. I opened an article that I knew, I definitely knew, was going to crush me. It was going to exacerbate my anxiety, make me ‘hate everyone’ for the time being, and leave me with so many overwhelming concerns. The online story was shared on Facebook. It detailed a woman’s survival, following a brutal attack and attempted murder in the Dominican Republic, while vacationing with her husband and another couple. I will not share all of the details, because that is her story to tell. However, I can say that I was impressed by how brave she was for speaking publicly, after such a traumatic, life-altering event.

Now, I will get back to what I detailed above… the anxiety… the horror! When I read her words, portraying the incident, I literally felt like I was there. I started to suffocate. Shear panic took over my entire body. I caught myself reading faster, faster, faster, because I wanted it to end… then to imagine actually being her!? It was a powerful piece - but it hurt me in the moment; it hurt me for her; it hurt me for women. She made reference, in the particular article that I read, about women not being able to walk alone. In some of her own words, she stated that she did not like having to say it that way, but that ultimately, sadly, it is true.

Let me also mention that she does say multiple times that this incident was not her fault… she did not intend to victim blame by her statement at all… she was essentially expressing how unfair and dangerous the world is.

After reading her story, uneasy and all, I had to go see a few patients at one of the locations I work out of. When my first patient arrived, there were a few people in the building. When I was walking him out, I realized the front door was locked and I was the only person left. This is not uncommon. Cool… I unlocked the door for him and left it open for my next patient. He should be arriving in a few minutes anyway, so I will just walk back to my office and finish some paperwork. I turn around… and there stands a man that I have never seen. My heart immediately jumps, but I quickly realize he is mopping the floor. I think to myself, ‘Oh… okay. Why have I never seen him before, though? That is weird… Anyway… just say hello…’ I attempt to make direct eye contact, because I am very serious about that, but he refuses. He turns his body away from me and puts his head towards the ground. I politely say “Hello!” to him, but he gives me a very short, stern “Hi” in return.

Whatever. Weird.

I go to my office and my patient walks in a few minutes later. We have an amazing session, working through a lot of issues and developing a short-term action plan until our next appointment. I walk him to the door - it’s unlocked (remember, I had unlocked it because I had to let my other patient out and wait for this patient to arrive). The gentleman, the person I have never seen in the building while consistently working alone during early mornings and later evenings, is no longer in sight. Again, I think, ‘Odd… but is it? Just lock the door and get out of here finally.’ I lock the front door. I walk back to my office and in my typical fashion decide that I am incapable of leaving that building until my progress note is completed and my billing is submitted. Don’t ask - that is a whole other blog post worth of information (haha!).

My mind starts racing! Hypervigilance? BEYOND! I am hearing odd noises. I am sweating. My heart is beating out of my chest. Catastophric thought patterns are my ONLY thought patterns. My head cannot get away from that man with the mop! ‘WHY have I never seen him before? Why was he so uncomfortable with making eye contact with me? Is he gone? Did he just walk out the front door or does he have a key fob like I do and use the back entrance? Wait, the front door was locked until I unlocked it… so he MUST have a key fob. WHY have I never seen him before?’ I recognize, even in that moment, that there are two things in play here: the residual effects of reading that article before work (secondary trauma) and my true intuition/understanding of when I feel uneasy or threatened.

My thoughts got so dark; I mean, SO dark. I called my husband, thinking that IF that man was still around and had ill intent then my being on the phone would disrupt his plan. Then my thoughts led to my history of watching crime shows and documentaries where I have learned that I actually should not be on the phone because it is lessening my senses to threats around me. I hang up. I text my husband my concerns. I call him again, because the fear is intensifying. He doesn’t answer. He had already planned to meet me after work a couple of miles from the office, so he was probably getting in the car. My stomach drops. ‘I am dead. Fight or flight… what do you in this situation? You knew you felt uncomfortable… why didn’t you leave right AWAY!? You did this to yourself now. You could have left, but chose to think this would not happen to you. Now, you’re going to be sexually assaulted, kidnapped maybe, but definitely murdered… Unless you can fight him off. Can you? Where is he going to attack you? Is he by the back exit? Is he waiting in a car in the parking lot so he can grab you when you least expect it. No… he is in here… wtffffff…..’ My husband calls me back. I detail that I am leaving RIGHT NOW because I feel SO afraid. He is confused. I do not normally get this way, according to him. I am gasping every few seconds, as I turn around or look in the direction of one of the pitch black offices, because I am so totally freaked out and on edge that everything is perceived as a threat. I literally asked my husband if it was dark outside already, because I wanted to determine if outside was going to be as terrifying as inside this building. ‘Babe… it is 7pm… it is totally light out…’ he says it in a continued confused tone, as if implying, ‘Are you serious right now?’ He doesn’t get it.

I make him talk to me on the phone until I get into my car and lock the doors. At this point, nowhere is safe and everyone is trying to murder or sexually assault me. Once I hang up, I still do not feel at ease. I am still concerned about my physical safety, however, the psychological warfare that I just experienced is the most painful. It is indescribable (other than the words above… but you get my point).

Why did I read that article? (Because you have to… you are an advocate for survivors of sexual assault, domestic violence, and violence against women… you enjoy reading their stories and applauding them for their bravery.) Why did some individual mopping the floor put my system on such high alert? (It was not just the article… trust yourself… look, you stayed to write that progress note trying to avoid your intuition and then literally felt as though your life was in danger… you then started beating yourself up for assuming that something so atrocious would never happen to you… why would you be so lucky?) Why did my husband not understand how severe my fear was or where it was stemming from? (Because you essentially never show any form of weakness and then you have to also take into account that he is a man; on average, men do not experience these fears or realities.)

The horror of being a woman. The survivor in that article that I read before work was right! We cannot walk alone. We cannot let our guard down. We will never experience lives that do not consist of threats to our safety or well-being… because we are women…

I stood there. Whether hypervigilant due to that article or not… I stood there! I felt I had something to prove. I convinced myself, despite my knowledge and the work that I do on a regular basis, I literally convinced myself to stand in fear because I wanted to “prove” that something like “that” would never happen to me. Thankfully, it didn’t. But WTF?

I honestly have no closing to this blog. I was emotionally, psychologically, physically …. professionally, systemically, politically … every “lly” you can think of… I was DRAINED, after the events of today. I guess to tie it all together, here are a few thoughts and some questions:

  • I am glad that I choose to refrain from watching horror movies these days. They are way too real and can be way too damaging to my psyche.

  • Are we (women) living the real horror movie?

  • Do I have to be afraid to be a woman? Is that silly to even ask?

  • How do we, as women, stand strong and fight against victim blaming/sexism, while also being comfortable to make a statement like the survivor in that article, i.e. we cannot walk alone - we just can’t?

  • Violence is real… it is so real. It does not discriminate against anyone.

DISCLAIMER: This blog is not in any way stating that men do not experience trauma, violence, sexual assault, etc. It is strictly speaking from a woman’s point of view and from my personal experience(s).

9/29/18 Out of the Darkness - Suicide Prevention Walk

On 9/29/18, I attended the American Foundation for Suicide Prevention’s Out of the Darkness Walk at Hart Plaza in Detroit.

I was so inspired by the thousands of individuals that attended the walk, shedding light on the many different ways that one can be impacted by suicide.

Thank you to my close friends/family that donated to my team and to the few that attended the event with me. Your support means so much to me!

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Out of the Darkness

Suicide Prevention Walk

I wish I didn't have anxiety...

High winds - a storm is coming

Grass needs to be cut

Higher winds - here we go

Curtains flapping in the wind... should I shut the windows?

Faucet dripping - drip, drip, drip, drip, drip, drip

Kids screaming in the neighbor's backyard... they never shut up!

Dogs wrestling

There is hair everywhere - I just vacuumed

When am I getting paid again?

I hate my body

Trees tapping on the windows

I have to let the dogs out

Breeeeeathe

I hate food prepping - I am starving - I shouldn't eat, though

If I go to sleep in this exact moment, I will only get 4 hours of sleep

Is it Friday yet?

The house next door has wind chimes - I hate wind chimes

Breathe, breathe, breathe

How can you just let your screen door slam back and forth in the wind like that?

Am I crazy?

Drip, drip, drip, drip, drip - I need to fix that faucet!

[vacuum sounds]... ahhhh, I feel better

Where did that crack in the ceiling come from?

How do you even fix a crack in the ceiling?

How much is that going to cost?

Wish I could just fix it myself - I am a failure

Count to ten - 1, 2, 3...

I forgot to put the laundry in the dryer! - Great, now I have to rewash it

Shut those kids up!

I wish I had a different life

I have a migraine

Just go to sleep - you're exhausted

I should paint that

Drip, drip, drip, drip

The family is coming over this weekend - I have so much to do

There is never enough time...

Breathe

Maybe I should go for another run

[walks outside]

Trees are squeaking and rocking back and forth

Dogs barking

We need a new fence

How much does that cost?

I wish I could just put it in myself - I am a failure

Count to ten - 1, 2, 3, 4...

[starts to rain, goes inside]

Drip, drip, drip, drip, drip, drip, drip, drip, drip, drip, drip

The basement is probably going to flood - great

I need a vacation - I can't afford a vacation

I am going to rip those wind chimes down

I can't breathe

Count to ten - 1, 2... why do I even try to count? - No, I have to... 1, 2, 3, 4, 5...

Can I ever have kids?

Do I want kids, when I cannot handle this?

I hate kids

Chaos

Anger

Frustration

Depression

Drip, drip, drip, drip, drip, drip, drip, drip, drip, drip, drip, drip, drip

Am I crazy?

I am losing my mind

Help!

I wish I didn't have anxiety...

 

I Go Back

"I heard it today and I couldn't help but sing along
'Cause every time I hear that song

I go back to the smell of an old gym floor
And the taste of salt on the Carolina shore
After graduation and drinkin' goodbye to friends
And I go back to watchin' summer fade to fall
Growin' up too fast and I do recall
Wishin' time would stop right in its tracks
Every time I hear that song, I go back, I go back

We all have a song that somehow stamped our lives
Takes us to another place and time..."

 

Kenny Chesney- I Go Back.  What a jam, right?  It is such a fun, summer song that can get you right in the feels at the same time.  We all have had those times when we feel something, hear something, smell something, touch something, or see something that completely warps us back to a different place and time.  It could be a song from high school that brings you back to the night you stayed out late and lied to your parents.  It could be the smell of a particular perfume that makes you immediately feel the presence of your late Grandmother.  It could be the sound of the city traffic that in that one moment transports you back to your 20s, when you moved far away from home, trying to make it on your own.  It could be the taste of a specific alcoholic beverage that reminds you of your first hangover.  It could be the fuzzy feeling of a pillow that makes you feel as though you are sitting on that 1970s couch that was in the basement of your parents' old house.  One sense can take you back to some of the most prominent memories in your life or to some from your past that you might not have even realized you still held in your brain.

Good times, huh?  Everyone loves those moments!  But imagine if the memories or places you were taken to were not so happy.  Imagine if they were dark, scary, confusing, anxiety provoking places.  This is similar to what it is like to experience a Post Traumatic Stress Disorder (PTSD) flashback.  A sound, an object, a scent, a person, a feeling, or a touch could trigger an emotional response to a previous trauma, i.e. abuse, neglect, violence, sexual assault, bullying, etc.  The way that you are sent back in time to a fond memory... a flashback does the same thing but in a negative fashion.  Sometimes, the responses that occur during a flashback can be so strong that the individual actually dissociates to avoid feeling them, meaning s/he basically detaches from reality or has an out of body experience.  Not only does this happen during the flashbacks, but it also could have occurred during the initial trauma itself.  To provide an example:  Some survivors of sexual assault have discussed how they have either "blacked out" during the trauma or watched the incident occur from outside of their bodies from say a bird's eye view.  They mentally detached themselves from the situation, as a defense mechanism to avoid actually having to feel or process what was happening to them.  Although the involuntary dissociation assists in reducing physical/emotional reactions to trauma or flashbacks, it is not a healthy response to addressing and overcoming these situations.  No one can live his/her life through utilizing defense mechanisms, dodging triggers, and avoiding emotions.

To work through any form of trauma, it is imperative that you find a therapist that you feel comfortable with.  It is difficult enough to get up the courage to attend therapy or discuss your "problems," don't make it worse by feeling stuck with a therapist that you do not feel hears or understands you.  Once you have built rapport with your therapist, make sure you do not re-traumatize yourself.  Sometimes, once we finally take the plunge to talk to someone about our life experiences, we end up dumping everything out on the table and cannot even control the rate at which our word vomit is flowing during the session.  Although the initial emotional release might feel freeing, you also might soon find yourself overwhelmed, on edge, depressed, confused, or distraught.  You have been suppressing your traumatic experience for what could be an extremely long time and now you just opened up that wound again.  There are many different ways that your body and mind could react to this.  Take your time.  Take a breath.  Slow down.  Process.  Heal strategically.  Of course, your therapist will guide you through this; however, it is important for you to also be aware so that you can prepare for anything that happens during or in between therapy sessions.

If you or anyone you know is struggling with PTSD/flashbacks and needs someone to talk to, please feel free to reach out to me.

May: Mental Health Awareness Month

Here are some simple things that you can do during Mental Health Awareness Month that will help to educate yourself and/or others:

  • Attend a seminar on mental illness to get better informed on the topic in general
  • Connect with close family or friends that struggle with mental illness, showing your support
  • Post on social media to either educate others or advocate for those diagnosed with mental illness
  • Talk:  Talk to senators, talk to your local mental health professionals, talk to your family, talk to your students, talk to your neighbors, talk to individuals that have been diagnosed with mental illness, talk to your coworkers... the more we talk about mental illness, the more we normalize it!
  • Volunteer in the community
  • Participate in awareness events, such as speak outs or 5ks
  • Challenge your own biases by researching and reflecting on mental health issues that tend to confuse you or strike a cord with you

There are many ways to get involved!  The choice is yours.