This is not about Sophia Yin.
I feel the need to say that before launching into a discussion about suicide and depression in the animal community, because the horrible news that she took her own life and the ripples it is causing in the veterinary world is the reason I’m talking about it today. But it’s not about her or her situation, which none of us will ever really know; Dr. Yin’s legacy is the work she did during her life, and it should remain that way. This is not about one person.
Whenever a tragedy like this happens, I see the same posts over and over: “Shocking. Tragic. Hold your loved ones close and tell them you love them. If someone seems to be suffering ask if they are OK.” And so it goes for a day or two, as we hug our kids and our spouse and our dog and then go back to work and assiduously ignore the suffering of those around us. Not that we recognize it most of the time anyway, but I’ll get to that in a moment.
One of the biggest misconceptions people seem to have about stress, burnout, and depression is that it is inevitably obvious to those around the person. I blame Zoloft ads for making us think all depressed people walk around weeping with little clouds hanging over them.
I think a lot of depressed people look like this:
You know how we always say cats walk around looking like a million bucks with BUN levels through the roof until one day, way past the point it was an issue, it’s finally too much but you never had a clue? A lot of depressed people look like that. So maybe this is a little more accurate:
They do just fine at work, and out amongst friends, and then come home and realize man I am not fine. But we’ve normalized stress in our lives to the point many of us don’t even necessarily recognize the signs of depression in others, and even in ourselves. I sat on the floor of the bathroom for four hours straight one day, when I was suffering from postpartum depression, and still had no idea that sitting on the floor of the bathroom unable to muster the energy to move two feet might be a sign something was wrong (protip: it is).
I don’t like talking about that time in my life, but I will because every time we censor ourselves from discussing these things we perpetuate the stigma that drives people away from seeking treatment. We are more scared of the consequences of admitting depression than we are the consequences of not being treated, and oh my god, how awful is that? I’m pretty sure the mental health professional community has been watching us in horror for years, waiting for us as a profession to finally say yeah, we could probably use some assists here.
So while asking someone if they are ok and offering virtual hugs is lovely and kind, I really think the time has come to try and do something a little more impactful. Open dialogue is a good place to start. So let me share some things that I have discovered over time, watching us wring our hands in despair over and over while we wonder what we could have done differently:
1. You would not believe how many other people out there are going through the same thing.
People at the top of their field, with lovely families and good jobs and beautiful dogs. People who seem to have it all together. And maybe they do, if they have good treatment.
2. I wish someone had told me about these things in vet school.
I thought I was the only person plagued by worry and self-doubt in school. In retrospect, ha! That was really not the case. Nonetheless, a little peer-to-peer support or support from people already out there would have been very reassuring. I believe we need to start letting people know at the start of their career, not at the middle or end, that stress/anxiety/depression/burnout are common, but solvable problems.
3. There’s support, although it’s hard to find.
Do you know what the hardest part was for me about getting through my depression? Figuring out who to call. My OB didn’t help, the psychiatrists she gave me the numbers for didn’t take on new cases, I wasn’t actively suicidal, and by the fourth call I was too tired to deal with it any more. So I laid on the bathroom floor for a few more days until I had the lightbulb idea to call my primary care physician, who was horrified and got me in that afternoon and life got a lot better after that.
I feel like our profession is still in the same place. Help should be very visible and easy to access, a rope already floating in the water instead of a life preserver someone has to yell for when they are drowning. Want to really do something to make our profession better? Help me figure out how to make that happen.
So you think you’re depressed/ burned out/ feeling off? Take a deep breath, you are in good company. You do not stop being a successful professional and accomplished person. Life can be good and you can still rock out and kick ass and laugh till your cheeks hurt. Here’s some places to start:
1. There is active peer support, through VIN, and on Facebook. A closed group has been started on Facebook for people dealing with these issues as well as their family and friends- to request membership, click here. Peer support is fundamental, though of course it is not a substitute for-
2. Calling your primary care physician, who if they cannot handle it themselves can at least get you where you need to go. I guarantee you every mental health professional out there is going “uh, of course,” at every thing I have said because they are experienced in these things, while we are not.
3. Stop googling. Seriously, all you will do is come out blaming yourself for not juicing enough and while it is a lovely way to get vitamins, it’s probably not going to be enough. Talk to a pro, just like we tell people to stop treating their dog’s ear infections with diluted alcohol that they read about on a yahoo group and go to the vet. Right?
4. VetGirl has offered their excellent webinar about suicide awareness available for free, for everyone. It is well worth the watch not for anyone who works in the field to help increase your understanding of the issue. You can find it here.
5. VIN is offering a webinar this Sunday at 9 pm PST to honor Dr. Yin and discuss “Dealing With You and Your Colleagues’ Stress and Depression.” My understanding is that this webinar will be made available to non-VIN members as well, so stay tuned as I get more information. Both webinars, by the way, are taught by mental health professionals who know their stuff.
I will be honest and admit I hate overly sentimental statements accompanied by soft-focus ocean pictures like “fall into my arms and I will catch you” and “the world is full of hugs if you just ask for them” and all that other stuff, so I will offer you my own personal unfiltered thoughts on this:
Depression sucks, and it’s real, a physiological crap storm of neurotransmitters, and if you are reading this experiencing a dawning sense of dread with unasked-for tears rolling down your face as you desperately say nonononononono I’m fine, you might not be. So call someone who can help so you can stop feeling miserable, ok? Do it today.
OK maybe one overly sentimental picture. But just one, and only because kittens. And with that, I demand some good news so we can get back to our regularly scheduled program of fur removal device discussions and derpy dog pics.
Just wanted to say thanks for handling the tough stuff as well as the derpy dog photos and furminators. -newish grad just trying to do the best she can
Thank you! These sorts of comments are what keep me going when I think, god, this is like the most depressing week of posts ever but I hope they do some good.
so important to not make this a stigma. so thanks for sharing. unfortunately the depression gene runs very strong in our family. I was fortunate not to get the worst of it although I didn’t get left out from that family gene. And growing up in a religious/faith based community, I can just tell you that “praying harder” is not the answer either. I heard a wonderful Christian man give a talk on depression and part of it was “take your meds if you need them.” If you were diabetic you would take your insulin, right?!
And the thing about where to start? I am amazed at how unavailable/unknown resources are for the general public. You are a smart, well-educated, medically savvy individual and it still took you a few days to figure out to call your primary doc. Think of all those people that have minimal education and a lack of understanding of the medical community altogether….. anyway, I am rambling but all that to say, as much as people can know it is ok to seek help for this intangible illness, the better things will be…. and if someone doesn’t know what it is like to feel depressed, listen to Natalie Merchant’s “Like the Weather.” thanks Dr. V!
I am so glad to hear that people everywhere are recognizing the importance of real, medical treatment. It’s a start.
I feel like you’re right on here, Dr. V. I was one of those “I’m okay” people. I hid my depression from friends, strangers, and family alike. I, too, am part of field where the incidence of suicide is high, but there are many resources available to us in law enforcement. Still, the stigma is crippling. People fear losing their careers or the respect of their peers if they open up about their struggles. Thank you for doing your part to make it okay to discuss this scary issue out loud.
It’s awful that the professions where the problem is often the worst- law enforcement, medicine, military- is also where people are the most afraid to seek help for the very real concerns for their career.
Well said Jessica. Very hard though. People with severe depression often do try and hide it and beyond that, even decline help when someone does recognize it.
There are 2 people I know right now that are in one stage or another of this, one pretty severe and as much as I try and help she “doesn’t want to talk about it” once we get down to really doing something. I offered solutions for her most immediate (safety) concern and she did not take action on it (after I got ALL the information for her) and although its SO bad that basically everyone knows at this point, including her employer, we all get a somewhat different version of what’s happening.
What do you do? I know this person my entire life but she is literally refusing real help. It’s a helpless feeling from over here…. and I fear for her, really. I feel like she needs an intervention but I can’t just pull her out of her life.
Okay now some good news – I’m as of last week officially 2yrs, 7mths cancer-free! Yay!
I highly recommend Dr. Kay Redfield Jamison’s books “An Unquiet Mind” and “Night Falls Fast” to give some glimpse into the mind of the bi-polar/manic/depressed person. As a doctor, she had the where-with-all to give her family legal permission to force her treatment when she went through the phase of “i don’t need any RX or any help”, which is a hallmark of these illnesses…
Dr. V, thank you for this post. Living in the bay area, we just lost Robin Williams and went through the same thought churning process. (I know, you all lost him too, but he lived here and we all saw him as a neighbor.)
Several years ago my employer chose to end her life and this is what it looked like: she returned from a 3 week trip to Southeast Asia – receiving an award for her work and lecturing on her area of expertise. She celebrated her birthday for 3 days with colleagues, family and friends. She shopped and bought some beautiful new suits (which she could well afford), got a new haircut and glasses. She went to movies with her grandchildren, she went whale watching with a Supreme Court Justice, she spent a day with her family, had a lovely dinner, went to her room, returned some phone calls, called the new neighbors who had just moved in next door and invited them to dinner…then she drank a bottle of vodka, swallowed a bunch of pills, tied a plastic bag around her head and died. This is true. Needless to say, everyone who knew her was shocked beyond belief. After I read Kay Redfield Jamison’s books “Night Falls Fast” and “An Unquiet Mind”, I finally had a glimpse into the world of the bi-polar, manic, depressed mind. For me, I realized that this is a place we simply can not enter…those of us who do not suffer these conditions. No amount of “if only we had known how badly they were feeling” can fix this illness. It takes constant vigilance and professional treatment and then, there’s no guarantee. No one is at fault here, especially not those who take the final act into there own hands.
CORRECTION: final act into THEIR own hands…
Thank you for sharing all of this. It is so important and goes back to what Annette commented below that it is so frustrating to be on the outside trying so hard to understand, to know how to help. I don’t know the answers, but from my limited perspective the one thing I think we can do better- at least in my field- is to increase awareness among people as they enter the profession, to at least help someone maybe be more aware of the signs in themselves and recognize what is happening early.
As a mental health professional, I can say, yes! you are right on Dr. V! The prevalence of depression is enormous in this country. Highly emotionally charged professions may increase prevalence. And there are countless ways people use to try to escape their private dark-cloud – alcohol, drugs, shopping, sex, gambling… but those things only mask the pain. Talk to friends, family, doctor, clergy, counselor, etc – get help, you are worth it.
Thank you, for this, and for the work you do.
Just want to join in quickly with a note that it is important to watch your children for signs of this as well. Often children show signs of anxiety, stress, and depression and are overlooked because parents and teachers don’t understand, and the kids are labeled as trouble makers, unmotivated, or stupid. I know. I lived it. Luckily, I was able to recognize in both of my children early on that they had anxiety disorder because I knew the signs.
We also, as a nation, need to make mental health care a more available option. Mental health is still stigmatized as bad or evil, and it makes it very hard for those of us who have any sort of mental health issues to admit we do have a problem and need help. Even worse, a lot of times when we do seek help, the help we need is near impossible to get.
I watched my bff struggle for years to get her son the proper help he needed through the system. Years. It shouldn’t take that long to help someone in need. If he had a physical injury or illness he would have been treated right away. But because he had a mental health issue it took years. I’m glad to say he’s finally on the road to recovery.
Sorry, guess that wasn’t a quick note. But this is kinda one of my hot points. Thanks for addressing it Dr. V. I wish more people would take that kind of time.
All so, so very true. Thank you for bringing up the importance of recognizing the impact this has on children. So much good could be done by catching this early. As my kids enter their teenage years this is one of my biggest concerns.
As always, an excellent article. Thank you for sharing. It is really an example of how things truly present, rather than how pharmaceutical companies would have us believe they present. Thank you for your honest, insightful and kind approach to a very difficult subject. I, for one, am now going to play with our resident kitten, because he makes me smile 🙂
Kittens make everything better, alwaya. 🙂
Thank you for a simple, brave, and sympathetic post. As someone who not only knows the state of mind that leads to depression but also a depression so deep that even suicide is too hard, I’m relieved not to see another “hold your loved ones close” post.
However those sentiments simply reflect people’s pain and attempt to understand something beyond understanding. What I will find most horrifying are the statements that suicide is stupid. Or that people who take their own lives are just selfish.
I’m glad there are people for whom these feelings are so distant that they just can’t relate. But people kill themselves because they can’t imagine any better solution. And sometimes, because they feel that this terrible and irreversible action is the least selfish thing they can do.
In my philosophy, Dr. Yin is no longer suffering. And for that I am thankful. I’m also thankful for the amazing work she left that will benefit animals and their people forever. I hope her family can find some sort of peace with their loss.
Thank you Pamela. I always hesitate to critique someone’s response to something like this because, like you said, people have so many different ways of responding and find different things comforting to them. The one thing I will always disagree with is, like what you pointed out, stating that someone in such pain is making a selfish decision- for all the reasons so many people have pointed out. It’s just not constructive.
As a mom who suffered through PPD undiagnosed for 11 months, awareness of the range of symptoms is huge! I thought depression- like you said- was weepiness, sadness, or at its worst suicidal. I was mostly none of those things. I had anxiety and no fuse. temper through the roof. I felt like a horrible person and the worst mom. I felt like I didn’t even DESERVE to have a real problem, I was just BAD. My PCP saw it immediately when I finally broke down and went to see her. I had wanted to crash my car into someone else, not to hurt me or them, but to just DO something with stress, anxiety, anger, etc! After 5 days on appropriate meds, I felt like an inkling of a human being again.
Thanks for being one of the ones to push an overall awareness of the issue, and not just put a cute and fuzzy band-aid on the most recent tragic event.
In all the things I’ve read about PPD I never saw that listed as a sign either, which took me by surprise because I feel like it happens all the time. And then once it’s treated there’s all this residual guilt and on and on and on and ick.
Thank you for this! I think one of the hardest parts is getting over the stigma and being able to talk about it. There shouldn’t be any shame, but there still is
There is, and I so get the fact that many people just don’t want to talk about it because of it. Baby steps.
Mental health is something so overlooked and stigmatized in this country. Be it depression or another form of mental illness, no one talks about it. I have struggled to raise a mentally ill child for the last 18 years, it is so hard to find help and it’s even harder to find people who understand, even a surface level, what it is like to deal with. Many people think’s it’s just easy advice… all she needs is love, or she’ll grow out of it, etc. In the end we end up being isolated because people truly do not understand and we have been sucked dry of energy trying to explain it over and over again or more sadly because people judge. I think people who are in the midst of depression face the same thing… and sometimes just telling someone you love them, or hugging them is not enough. The biggest misconception is that people who are depressed and/or facing mental illness are completely tapped into reality, when that is not the case. Their perception is likely skewed, and someone really is not safe until they get good therapeutic treatment and that perception shifts, which takes time and patience. I see it all the time with my daughter, she is in her own world although she participates in our world… her perceptions define everything and most of them are not based in reality. We need society to get educated, to treat mental illness for what it is… an illness. We should be able to get the best treatments, have time off work to heal, etc. But most importantly, we should all feel safe to discuss it out in the open.
So true. The perception shifts can be disconcerting for everyone involved. Thank you so much for sharing your story and I wish your family all the best.
Thank you for this post. Depression runs in my family and I am the one out of my immediate family who got the lion’s share of it. Thinking back to my childhood, I have suffered from it for almost as long as I can remember. My family did not believe in getting help, even after my first suicide attempt as a freshman in high school. I finally got help for myself when I turned 18 and got a job with insurance. My depression was still not taken seriously by my family. My mother was the harshest critic (my Dad was killed when I was 16 making my depression worse) and could not understand why I could not be like my two younger sisters. I think that the lightbulb went on in her head about how serious it could be when I attempted suicide for the second time when I was 25. Now she “gets it” and will tell me to take my antidepressant as it is necessary just like someone who has diabetes must take their insulin. I will have good years when I can stop taking them and do great but then that dark hole comes back and I immediately go back to my doctor. It is a shame that people stigmatize mental illness as so many people suffer with it and won’t get the help that they desperately need due to the stigmatism. I am grateful that I got it even though my family thought I should just “pull myself up by my bootstraps” and get over the sadness. I am also intensely grateful for my friends, husband and my mother-in-law who all are there for me through my most difficult periods of this horrible disease. This is actually the first time that I have spoken about it “in public” because of the stigmatism. I can tell you that attempting or committing suicide is not selfish. It is thought of as a way to stop the pain as the pain seems like it will never recede. Thank you again for this wonderful important post.
Thank you so much for being brave enough to share your story here. I am honored you chose to do so. I am so glad you have a good support system to help you- it means so much.
As a VIN/VSPN employee, I can tell you the special session this weekend is NOT available to support personnel BUT the transcript will be once it is completed sometime next week.
So, it is free trial for veterinarians for the live event if they are not on VIN and then the transcript will be available for anyone?
Exactly. Non – VIN member veterinarians are welcome to come. Transcript is available to all VIN/VSPN members within a day or so. 🙂
There is a National Suicide hotline. 1-800-273-8255. I wanted to add to the list.:)
Bless you Dr V for sharing a tough time in your life, and giving people resources. You are a blessing to the world.