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By Margaret Fiero MA, LPC-Intern and William Schroeder, MA, LPC
When it comes to Western medicine, the connection between mind and body could be described as tenuous at best. We are conditioned by our culture and our healthcare system to think that if we have a problem with our foot, our foot alone should be treated and healed, without any thought put to any other part of our body or mind. This philosophy translates to mental health as well. I work with clients who have primarily had some sort of serious mental health crisis, and often find myself surprised by the lack of knowledge around the relationship between physical health and mental health.
Avoiding Easy Answers
Who are among the first professionals that we spill to our mental health struggles? Well, alongside hair stylists, that would be the family physician. This is partly because conditions such as depression, PTSD, etc., often appear first as physical symptoms. Stomach problems? Sore muscles? Migraines? Heart palpitations? Those could be signs of many problems, including depression and anxiety, though they’re often not treated that way. Fortunately, there is an Austin family physician who does see the importance of a holistic approach to medical care. Dr. Stephen Blair, based at UT Austin, has twenty years of experience as a physician. Despite the years he has under his belt, he maintains a certain humility, acknowledging that there’s “nothing more satisfying than saying to a patient, ‘I know what’s wrong. I have an easy test that can prove my theory and a safe remedy that will resolve your issue,’” while be fully aware that it’s usually not that easy. Those of us who have been to a family physician when we’ve felt sick – which I believe would be most of us – know that’s the truth. Aware of this failing of Western medicine, Dr. Blair sees himself as more – and perhaps less – than the all-knowing good doctor. Rather, he strives to be “part physical scientist, part detective, part translator, part counselor.” One way he employs this approach is to screen annually for substance use disorders, which can be insidious and often hidden behind other health maladies.
Wearer of Many Hats
Dr. Blair’s description of himself as a medical professional who wears many hats is an apt one, as he sees patients with many presenting issues. He is the practitioner you go to when you have everything from a cold to serious depression. Speaking of depression, how does Dr. Blair approach such a delicate issue?
“Since Depression and Anxiety and Bipolar disorder have such varied symptoms, they can often ‘present’ the same clues as hypo- and hyperthyroidism, sleep apnea, anemia,” among other common disorders, says Dr. Blair.
No wonder so many individuals end up at their family doctor’s office with a physical complaint, when in fact they are struggling with a mental health issue. After all, when mental health issues are not treated or are ignored, they often end up manifesting as somatic, or physical, problems.
It’s not only the doctor who prefers an easy answer. Dr. Blair admits that one struggle when faced with patients with mental health issues, is that they often look to tests and procedures, such as MRI’s, for answers. It’s understandable, as we would all prefer to deal with something tangible like test results than the uncertainty ahead of us when given a mental health diagnosis. Denial can also be a roadblock to treatment that requires work to overcome. Dr. Blair says that many “patients at least initially don’t want to accept or believe that depression is an issue in their lives.” Getting patients to agree to “talk and/or medication therapy” if necessary is another undertaking in itself.
“Once that initial inertia is overcome and the patient has bonded with a therapist… and we have found an effective medication,” says Dr. Blair, “The patient usually has an attitude similar to ‘Why the heck did I wait so long to do this?’
Dr. Blair says that the best approach is making a plan and sticking to it. “Improvement is the rule when the process is embraced.” Mental health most certainly requires cooperation by the affected individual; it isn’t just about taking a pill. Treatment is most successful when the patient or client is compliant with both medication and therapeutic modalities. In light of the many current issues with our healthcare system, it is encouraging to know that there is a doctor out there who realizes the importance of getting the patient on board as an active participant in their healthcare, rather than just “treating” them. Thank you to Dr. Blair for spending time with us on this subject.