S1E5: Are psychiatrists mind-readers, pill-pushers, or anti-Christian?

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Transcript for S1E5

Hi, welcome to is like this podcast your common sense mental and spiritual health talk show where we answer your questions and explore your world. One episode at a time, this podcast might be for you, if you want to be a wiser, stronger and more in-tune human being. I am your host, Dr. Uejin Kim, a dual board-certified psychiatrist, and also a fellow human being walking alongside you on this journey. So let's start walking.

In this episode, we're going to be talking about the three most common misconceptions about psychiatry and psychiatrist and probably answer some of your fears about seeing a psychiatrist.

So when I'm in a social group, and they find out that I'm a psychiatrist, a lot of people just freeze and ask, Are you assessing me right now? Or can you read my mind right now? And the short answer is no. But in my looks, we can read minds, because we are trained to analyze how the mind and emotions and behaviors are connected, and how data is connected with our body. So a little bit about psychiatry training, you know, after college, four years of college, we have four years of medical school. And this is where we get the most initial superficial level of all the organ systems and how they all work together. And in the span of the four years of medical school, we choose something called specialty. So it could be neurosurgery could be general surgery, it could be psychiatry, could be pediatrics. So this is kind of like our training ground. And this usually lasts from three to five years, sometimes you can go more. So this is what we call residency training. And then after this, crazy people get more training, called fellowships to sub-specialize within their specialty. So for me, I was crazy enough to finish the general psychiatry residency and then wanted more training to treat child and adolescent behavioral issues. So I got a fellowship in that. So this fellowship lasts usually one to two years, but sometimes it can go more. So during this time of, you know, three to five years of psychiatry training, you know, we see numbers of patients and different cases, extremely rare cases, extremely common cases. And we talk about medications and other treatments, other emerging treatments. And this is all we do for three to five years. So you can imagine that we've heard a lot of stories, we've heard a lot of presentations of depression and anxiety. And this is why we start to develop a sixth sense of what the patients can present. And of course, it's not foolproof. So now we're trained to kind of differentiate from schizophrenia psychosis from anxiety-related psychosis, you know, how depression shows up in children and how that's different from adults. And this is how we can lead to our assessment and diagnosis. So you can imagine why it looks like we can read minds, because we have studied the mind for a very long time. But to answer your question, in short, the answer's no, we cannot read minds. Now the second misconception about psychiatrists that I hear is psychiatrists just want to medicate people. And I can't say that you know, every psychiatrist you met wasn't like this. And maybe they were like that. But medicating a person has a risk. And psychiatrists are very well aware of that. And our first responsibility as a physician, is to do no harm. When we were at the medical school, we do a Hippocratic Oath, which is I will not harm a patient. And this is our responsibility slash liability. Of course, we're humans and human errors do happen. But as far as our intention goes is to help not harm. So like I said, every medication has its benefits, but as also has risks, and as a physician/psychiatrist, you have to know all the benefits versus the risk of each option and present that to the patient in the best way possible, and let the patient decide what is best for them. Now, there is a risk of not treating your depression and not treating anxiety, and I think you guys will know that firsthand very well, especially if you have depression and anxiety. So there's a lot of fears about psychiatric medications, you know, given that these are the medications that work in the brain, and your mood and your thoughts. So I totally understand. I'm just going to take a moment to explain how psychiatric medications work and how are not The mechanism of it is not that different from other medications. SSRI is a group of medications under the umbrella of antidepressants, and a stands for selective serotonin reuptake inhibitor and the names that you've heard of like Prozac and  Zoloft. These are examples of SSRIs. The So brain is a part of the nervous system. You know, I mentioned that in medical school we learn different systems. Different systems like kidney, the lungs, heart, and brain. The brain is a part of the nervous system. The brain is a control station. And the nerves throughout your body is like a highway. and brain is a control system that controls different parts of the body through messengers that go on the highways. So messengers are like enzymes and neurotransmitters. Messengers are like cars that are traveling to and from the brain, to deliver messages and gather messages to the control center. And serotonin is one particular car. And I would like to think of serotonin as kind of like an entertainment business cars, that provides entertainment and happiness and lessen anxiety. So more entertainment cars, more fun, and less depression and anxiety, more serotonin, less depression and anxiety. Just like there are things that make these cars there are things that break down these cars, so I'll call them as like towing trucks, okay, they're transporters or towing trucks, that takes away extra cars that your body might not need. But the whole point of depression and anxiety is that you want more serotonin cars around. So what SSRI does is that it stops these towing trucks that tow the serotonin cars, so that less towing trucks, more serotonin cars on the road, and that's our SSRI works. And there are other medications, you know, and for different systems that work very much like this. Essentially, it increases or decreases the number of cars that are on the highways. So one example is an ACE inhibitor for high blood pressure. The ACE inhibitor is an angiotensin-converting enzyme inhibitor, also known as Lisinopril Enalapril. Any pearls, okay, what ace inhibitor does, it inhibits that angiotensin-converting enzyme, which would have narrowed the blood vessels. So if you're inhibiting what narrows it, then it widens the blood vessel. So the mechanism of SSRI selective serotonin reuptake inhibitor is not that much different from ACE inhibitor. Now, some of you could be still saying, you know, but SSRI can alter the mind, and ace inhibitor doesn't affect the brain or the mind. And I totally understand that concern. But I will also like to mention that there are other things that are mind-altering that mind seem harmless. So behavior such as like having an addiction, exercise, socializing, and meditation can be mind-altering. And other substances, like other medications, even for thyroid or steroids can alter the mind. And also things like coffee, substance, like alcohol or drugs. And also natural supplements can also alter the mind. So before you kind of rule out, you know, psychiatric medications, because it's mind-altering, I'd like to just kind of pause and consider because there are many other things that you're probably already doing, that are mind-altering as well.

 

So the third most common misconception that I hear about psychiatry, is that it is anti-God. So I'm gonna be trying to explain something that is very even more complex than the brain function. And this is just from my personal understanding, and it could change, so don't hold it against me if I rub you the wrong way. And a disclaimer here, my background is the Christian faith. At one point in my life, I consider myself an agnostic. So I'm going to try my best to make these concepts as universal as possible. But some of the content that I'll be discussing is from Christian background. I have a lot of patients coming from cultures that are not as accepting of the presence of mental health, right, or from religious background. And it's usually the parent figure who brings in their kid with behavioral issues or emotional issues. And I could already tell that the parent has preconceived notions that this is not mental health. This is just behavior. This is not mental health. This is just attention-seeking. And I think there is an apprehension in these cultures and religious groups because it really sounds different. It really sounds outside of the box of what they were aware of they're exposed to and what they were believing to be right accurate. or legitimate. And I heard a story of a guy. And this is kind of like a story to illustrate a point, there was a guy who was in the middle of the flood, and he was praying to God, Hey, God saved me. And, you know, flood levels rising, he's kind of on the first floor, and he's praying for God to save him. And for him, his expectation of God saving him was bringing down the angels and the cloud opening, and then he will be transcended, to safety. Police raft kind of came by the door and said, hey, hey, there's a flood in the neighborhood, you have to exit the building. And he told the policeman, hey, I'm good. God is going to save me. And then the flow continues to go up. And he goes to the second floor, because the water levels rising, and he was praying, God, please save me. And he still had the expectation, how he should be saved. And then at this time, a firefighter and the raft came and saying, the water level is continuing to rise, you know, please jump on the boat, we can get you to safety. And he said, No, I'm good. God got me. And I want to be safe this way. So he refused to help. And the water level continues to rise, and he's on the roof. And he's praying, God, please help me, you know, rescue me from this horrible flood. And at this time, another wrath came in. And you know, they asked if he wants to be saved, and he refused again, saying that God is going to help him. And he eventually succumbs to the flood, and he wants to heaven. And he asked God, why didn't you save me, and God told him, I sent you his help to get saved three times, and you refused it. And this was kind of like a funny and sad story. And here, I'm trying to illustrate that. I think sometimes when we're so in this bubble of a set of beliefs, and there's a rigidity to how you're expecting God to act, you miss out on the rest of your life. And here in the story, what the man missed was God can use earthly means to talk and help and engage with us. And also that God can use heavenly means or earthly means, and that we cannot limit God on what he uses, and how he uses it. And remember, this man held on to the expectation of how he thought God should help him he was expecting God to do what he wanted God to do not have this open idea of how else can God help him outside of his expectations. And this has to be done by growing in trust and faith in God, who is actually in control over science and medicine. So just because it's not in the black and white text of the Bible, doesn't mean that is not from God, or that God can use it. Mental health is essentially the wellness and health of your mind and how it relates to your emotions and behavior. And I hope that this podcast depicts that the mental health concept wasn't created by the millennials, and that the concept of mental health and even just mental health, in general, predates all forms of culture and religion. It was just part of your body's health. My heart is my heart of telling those messages. Ignoring mental health can not only hurt you, but those around you. And this is so key is just really, this whole podcast is out of love. Because I want everybody to love each other and understand each other in a whole new way. And I think that is the world I was designed to be because the more that I study my faith, and also the more I study mental health, I see how similar it is, I see so much overlap between two worlds. And I just see God bigger than just the division of politics and lingos and beliefs. I see God so much bigger than that. Now, while finding a psychiatrist with a similar religious value might be ideal is not always feasible. But what's the end goal of the appointment? The end goal of the appointment is the psychiatrists with their knowledge can assess the pattern and burden of your mental health issues and give you back awareness and control over your mind, emotion, and behavior. So that you can have control over your future and then can move on to living the life more aligned with your values. So as long as that is accomplished, you know the goal is met for the appointment and know that just because you're working with a psychiatrist or admitting that you have mental health disorder, doesn't mean anything about the legitimacy of your faith. And also know this that just because your psychiatrists prescribe you or assess you in a certain way, doesn't mean that that's the truth and that you have to agree to follow it, you know, just like Hippocratic Oath. There's a pillar of values and medicine and one of them is autonomy. autonomy means that a patient has a right to choose what is good and what seems right about their care. Doctor’s job is simply to offer service and educate the patient. “These are the pros and cons of each treatment option and not treating option.” So at the end of the day, don't feel rushed to make the decision don't have to agree with a diagnosis or even the treatment option, and a good psychiatrist or physician should always 100% honor autonomy.

So in summary is like this. Today we answer questions like do psychiatrists can read minds? No, we cannot read minds to psychiatrists love medicating people. No, we don't love medicating people. And psychiatry medications are not the only mind-altering substances out there. And the mechanism of it is very similar to other medications like blood pressure medications. And the last point that I wanted to make was, that just because culturally or religiously, you're not exposed to understanding mental health doesn't mean that it doesn't exist. And that mental health is not just a modern concept and it's actually just the health of your mind. And I got to explain the heart of creating this podcast because I wanted to explain mental health in a way that is so understandable and universal to different parties. And I just hope to bridge the gap with this podcast. So thank you so much for listening. And the next episode, I'm gonna be going back to cognitive behavioral therapy concepts. And have you ever thought that your mind is playing a trick on you and you're just getting more anxious and more depressed? So these are little tricks called cognitive distortions, and I'm going to be going in-depth to explain why you might think that your mind is playing tricks on you. So you have to come back to the next episode. I look forward to talking to you again and have a great day.