President's Column | May 2023

May 29, 2023

Dear Colleagues,

As I write this there are currently, what feels like 87 browsers open in my mind, the same number as my iPhone. That is common for someone with my personality…always multitasking. I am a type A personality through and through and while it allows me to accomplish a great deal of goals, it can also be a double-edged sword. My need to “do it all” all the time can create a lot of stress and anxiety, that I am guessing many of you readers can relate to.

May is Mental Health Awareness Month and I would be remiss if I didn’t bring attention to this important issue and share my experience with it. My hope is that even one of you reads this and thinks “I am not alone” and feels comfortable admitting and possibly sharing their truth regarding mental illness.

My story begins with the birth of my first son 10 years ago. I was diagnosed with postpartum depression two weeks post-delivery. The feelings I experienced were foreign to me and I truly felt like I had no control over any thought or feeling. I remember feeling so overwhelmed and afraid I would feel this way forever. Throw in the new mom guilt and I was a ticking time bomb. Luckily, my husband intervened out of concern and contacted my doctor. I was diagnosed with postpartum depression, or PPD, and started on medication. It was a shock. Me? Depression? No way. However, within a few weeks, I began to feel more like myself. Eventually, I felt so much better than I had even pre-baby that I decided to stay on the medication permanently as my doctor informed me that the depression can last varying lengths of time depending on the person.

Fast forward to 15 months ago and the birth of my second child. My doctor and I had a plan and faced the likelihood of another round of postpartum depression head on. I reluctantly saw a psychiatrist during pregnancy to ensure my feelings and medications were safely and effectively managed and continued after the birth of my son. Sadly, I experienced PPD again and even with the plan it affected me, even more than the first experience. It still affects me. I’m still on medication. I’m grateful it is available. I am happy to take it.

Prior to having children, I had always been anti “medication.” Medication as in mood stabilizers or anxiolytic agents. Crazy right? I am a healthcare professional who knows that mental illness is real. One in five adults lives with mental illness in the US. In 2021 it was estimated that 57.8 million American adults struggled with what can be a debilitating and sometimes deadly disease. So, why had I previously had a negative outlook on seeing a psychiatrist or taking medication for mental illness…. stigma.   

Stigma. Six letters that will prevent a sick person from seeking medical care. How can a single word carry that much power? Well, it does. It has the power to make a person scared to admit how he/she feels, prevents people from befriending others, inhibits sufferers from getting a job and affects the way they are treated by a medical provider.

As PAs we strive to provide a holistic approach to patient care, and with this we must acknowledge and guard against allowing ourselves to fall victim to the stigma associated with mental illness. Patients may be experiencing mental illness as a result of their dermatologic condition, such as hidradenitis suppurativa, psoriasis, acne or atopic dermatitis.  It can also be completely unrelated, but if we ignore this critical aspect of a patient’s health, we are doing them a grave injustice.

Likewise, we should remember that we are human and thus will be a patient ourselves at some point in time for some ailment, mental illness included. We cannot let ourselves fall victim to the stigma surrounding this sensitive topic. It can be challenging, as it was for me, to accept that we need medical care just as everyone else. We cannot always manage our own symptoms, self-diagnose and treat ourselves. If so, we are doing ourselves an injustice and perpetuating the stigmatic cycle.

As a healthcare provider with a history of depression it was difficult with my first pregnancy to admit to myself, much less anyone else. I feared I would be seen as weak and vulnerable and potentially not competent to perform my job. However, over the years, especially the last one, I realize that my mental health and my ability to seek help when needed affects my ability to provide the best care for my patients. It also allows me to be a genuine advocate for their wellbeing both physically and mentally.

As we finish out this month, I challenge you to know the signs and symptoms of depression and other mental illnesses and inquire about your patients’ mental health when discussing their dermatologic complaints. They may not openly divulge that they are struggling with depression or anxiety without your inquiry and compassionate bedside manner. You may be the only person who has ever expressed concern thereby opening the door for them to speak their truth.

Likewise, I challenge you to be reflective and not ignore signs and symptoms of mental illness in your own life. The daily stressors, emotional demands, and work-life imbalance of a medical professional’s job can lead to chronic stress and burnout and can dramatically impact the quality of care that we provide to our patients.

We took a Hippocratic oath regarding patients’ care. However, let us not forget we owe that same commitment to ourselves. Prioritizing my mental health has positively impacted my life, both personally and professionally, translating into positive outcomes for the patients I serve.

Yours Truly,

Lauren Miller, MPAS, PA-C, President, SDPA Board of Directors