DR. LEE'S BLOG

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On Severe Psychiatric Illness Left Untreated

The New York Times recently ran a captivating article about a talented young woman named Nakesha Williams and the huge impact that mental illness had on her life.  The article, which you can read here, describes the enormous potential of Ms. Williams in her younger years.  She served as class president during high school and went on to attend Williams College, where she continued to excel.  After college, Ms. Williams was a beloved teacher for a few years, but then the arc of her life began its downward turn.  Over the course of years, she became increasingly ill, and notably paranoid, which caused her life to become more and more unstable.  Friends and family repeatedly urged her to get treatment, but she refused to do so.  Her life continued its painful downward spiral until she ended up homeless on the streets of Manhattan, where she passed away, suddenly, of a pulmonary embolism.  

 

Her story is compelling and sad, and a reminder of how devastating severe mental illness can be when untreated.  In prior generations, there were no good treatments for psychiatric illness, and people with psychiatric illness suffered greatly with little respite, as in Ms. Williams's case.  This changed dramatically with the advent of modern psychiatric medication, starting in the 1950s.  Today, we are fortunate to have powerful, safe medications to treat psychiatric illness, which, combined with psychotherapy, can greatly alleviate the suffering that results from psychiatric illness.  But even the most potent psychiatric medication can be of no help if a person does not want to use them, as in Ms. Williams's case.  Education about psychiatric illness, especially about how it is a disease and not a moral shortcoming, can often be helpful.  If a person does not want to take medication, psychotherapy can often be helpful as well.  Reading about Ms. Williams's tragic life, we can't help but wish that she had received mental health treatment, and to imagine the life she might have had with good treatment. 

-Posted on March 5, 2018. 

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On Smartphones and Mental Health

The September issue of the Atlantic Monthly has an interesting article about smartphones and teen mental health, which you can read here.  The article suggests that as teenagers spend more time on their smartphones, they become more unhappy and more depressed.  

 

Smartphones have certainly changed our lives in fundamental ways.  Like all new technologies, they bring both good and bad.  As the article notes, smartphones make it easier to isolate oneself and to connect with others via app or text and not via good old-fashioned human contact.  There is also the concern that cyberbullying is more pernicious than in-person bullying.

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Having said that, there is much to be said for the good that this powerful technology brings, in keeping us informed and helping us connect.  There are also many leaders in the field who are thinking about ways to harness this technology to improve mental health, like Thomas Insel and the folks at Google.  You can read a little about those projects here.

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There is much we don't know yet about the effects of technology on mental health.  What we do know, from the Adolescent Depression Awareness Program (ADAP), is that mental illnesses like depression are common in both teenagers and adults, and most importantly, that they are treatable and that with the right treatment depression can resolve and people can live fulfilling, happy lives.  You can click here to learn more about the Adolescent Depression Awareness Program (ADAP), a wonderful program that brings powerful, much-needed education about depression to teenagers across the country.  You can also click here to learn about mADAP, which is ADAP's smartphone app that provides helpful information about depression (and which is also an example of a way that smartphones can have a positive effect on mental health).

-Posted on August 17, 2017.

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On Lawyers, Work, and Happiness

There was a recent article in the New York Times about a lawyer who struggled with substance abuse.  You can read it here.  The article tells the story of a talented attorney who lost his battle with substance abuse and goes on to discuss the high rates of depression and substance abuse among lawyers.  It notes a 2016 report from the Hazelden Betty Ford Foundation and the American Bar Association which found that 28% of lawyers struggle with depression, 19% struggle with anxiety, and 21% qualify as "problem drinkers."  The article further notes: "According to some reports, lawyers also have the highest rate of depression of any occupational group in the country.  A 1990 study of more than 100 professions indicated that lawyers are 3.6 times as likely to be depressed as people with other jobs."  

 

The article discusses how law school and legal culture may contribute, noting that "law students generally start school with their sense of self and their values intact" but that "the formal structure of law school starts to change that."  "Rather than hew to their internal self, students begin to focus on external values... like status, comparative worth and competition," and "come out of law school significantly impaired, with depression, anxiety and hostility."  

 

As a former lawyer turned psychiatrist, I found this article compelling on many levels.  It is a great reminder of the tremendous impact that the work we do, and the culture of our workplaces, can have on our mental health.  Medications are incredibly important and powerful in psychiatry, but there is also much we can do to decrease work-related stress and find meaning in our work and our lives, which can contribute greatly to our mental health and well-being.

-Posted on July 25, 2017.         

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