Major Depressive Disorder

So You Don't Want to Go to a Psychiatrist!


By Louise from her own experience with depression
Written for Internet Mental Health
February 1998

Our society still manifests old-fashioned and ignorant ideas about psychiatrists. This was the case with me. It was the case also with many people, whose opinions I both valued and feared. During the past year, I suffered a severe depression. It began in February. I did not receive any kind of adequate treatment until October when I finally went to see a psychiatrist. What hindered my seeking medical help from a psychiatrist for so long?

Fears

  1. First a strong sense of denial of my problem. I was a professional whose career depended on my mind. My brain had to be well. I could easily accept a broken leg or arm, but not a broken brain. If I were to be mentally sick, my life would collapse.
  2. Then a sense of shame. I, go to a psychiatrist! Psychiatrists treat people with mental illness. I can't be mentally ill! Oh, please, anything but that! I live on my own as a widow. I simply can't be mentally ill. Who will take care of me? How will I work? If I have to stop working, how will I ever get back to it?
  3. Then a sense of fear. What if I were to go into a psychiatric ward in the hospital? The shame! Who would ever visit me there? Other diseases that bring hospital stays are honorable. People bring flowers and gifts. People come to visit. But in a psychiatric ward! Everyone will be too embarrassed to visit. Oh, it will be terrible.
  4. And my career! If I were in a psychiatric ward, my career would be at an end. I could never hope for promotion. I would lose all respect from my fellow workers. Death would be better than so much shame. How could I return to my normal pattern of activity?
  5. What will the psychiatrist do to make me well? Evidently these doctors just hand out pills and assume that these will take away all problems.
  6. Or perhaps the psychiatrist will dig up all my past! In my depressed state, that is the last thing I want to go through.
  7. People who were mentally ill, it seemed to me, were somehow responsible for their illness. In some way they did not think correctly or hold the right attitudes. So it must be with my depression. I must think myself out of it. I don't need a psychiatrist to teach me how to think. Will-power: that must be the key. Every one is advising me to snap out of the despondency and to think in a positive way. This seems to be a better route than psychiatric help.
  8. If anyone knew that I was going to a psychiatrist, how could I face that person? What would the people I work with think? Would there not be a permanent medical record of my visits, suggesting mental instability? Would not this record harm me in my career?
  9. I was skeptical. What could a psychiatrist do anyway? How can he or she get into the brain? How can patterns of thought be changed? Would it not take endless sessions to go through my life and to bring a positive form of thinking about? No doctor can change my past and the traumata that I have suffered.

These were my thoughts and prejudices as my depression became worse and worse. I tried every means I could think of to get better: diet, positive thinking, exercise, visualization techniques. Finally, in desperation, I agree to see a psychiatrist. With halting steps I enter his office. Everything within me cries out: “you are a failure!” “Look at the type of doctor that you have to see!” “What if someone else were to find out that you were here.” My anxiety and depression become intensified as I await the encounter with the psychiatrist.


Changed Views

How different the reality from what I had feared. I meet with someone patient, gentle, and compassionate. The fears that I had experienced are dispelled as follows (treated in the same order as above):

  1. My problem does exist and is very real. I am taught that depression happens to people, sometimes with the cause most obscure. It involves a chemical imbalance in the brain, one that needs to be righted. I am assured that depression can be treated. Even with mental illness, life can be carried on in a productive way.
  2. There is no shame in going to psychiatrists. These are individuals trained in illnesses that affect the mind and brain. Depression can be treated and, if the medication prescribed is faithfully taken, one can continue to work. It is a common view that it takes a very long time to get an appointment with a psychiatrist. This is usually not the case in an emergency if the general practitioner makes direct contact by phone with the psychiatrist.
  3. The fear of having to into a psychiatric ward is real. Depression usually can be treated without hospitalization. But if one did have to go into hospital, true friends would be supportive.
  4. Psychiatrists do hand out pills. In the case of depression antidepresants can bring about wonderful healing. Antidepresants have bothersome side-effects but these gradually diminish. The end result can bring great hope of healing.
  5. Psychiatrists do study the whole psychological history of a person. But the timing of psychotherapy is crucial. At first the psychiatrist gently encourages the patient to stay on medication. Only when a great improvement in the depression has occurred does psychotherapy begin. Perhaps the cause of the depression can be discerned. Certainly help with current behavior can be given. Fears can be dealt with; loneliness discussed; anxieties examined.
  6. People who are mentally ill are victims. Mental illness is something that happens to someone. No amount of right thinking, visualization, or acts of will can make someone well.
  7. Medical records are very confidential. One need not fear their being made public. The truly compassionate person will not condemn anyone who sees a psychiatrist. Those who criticize and blame are sadly in need of education.
  8. Psychiatrists can truly help. They provide an objective view of one's past. They can offer valuable suggestions on how to cope with present problems. Their awareness of a whole range of abnormal behavior allows them to help one to adjust to different situations in life. For more serious cases of depression and mental illness, they can prescribe medication that can be life-restoring.

And so my advice would be: gladly and gratefully go to a psychiatrist!

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