Labels that stick

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It’s a long story. I was a junior doctor, early in my professional journey when I sought help for an emotional crisis. I believed what the more senior doctors told me. I thought I was being responsible in going to them for help. I thought they were the experts and that I must follow their instructions. In fact, I was sure I was doing the right thing, just what my professional regulator, the GMC told me I must do.  
That was how regrettably, I became subject to the biomedical model of psychiatry. I earned a label of depression. It was as if I had been branded, literally marked or stigmatised. I might as well have had a label stuck to my forehead with super strength tissue adhesive.  
‘Depression’ meant more than just sad — it meant weak, vulnerable, unreliable, unable to take decisions, fit for exploitation. Several drugs later and the label was added to — it became ‘major depression’. Several years later, ECT, more combinations of more drugs, the label became — ‘treatment resistant major depression’. Finally, all hope of recovery was lost and the label became ‘intractable severe major depression’ 
Seven years of failed treatments opened the doors which led to my involvement in a research project. I became one of the guinea pigs and as a result I succumbed to an experimental treatment of last resort -brain surgery- NSMD ‘Neurosurgery for Mental Disorder’. I was desperate and still convinced that ‘they’ – the expert psychiatrists knew better than I did. Truth be told, I was in no fit state for anything as by then I had been detained (sectioned) for over a year, literally a prisoner forced to reside in a mental hospital, deprived of my liberty. I was compelled to take high doses of multiple medications and at times was given ECT against my will. I thought of myself as highly suicidal, although the reality was not that I wished death, I just wished the nightmare would end. There was no hope and part of the reason, I became so adept at self harm was to punish myself for being such a failure.  
Apparently, I had fully consented to the brain surgery, although I had to ask what exactly had been done afterwards.  
It was 8 days after the operation that I had an epiphany. It felt very physical when a light switched on in my head and it was certainly real and life changing. In an instant, I stepped out of the vicious cycle of hopelessness and despair — I didn’t understand what had happened, nor did any of the psychiatrists. It hadn’t happened to any other patient before or since. 
At least, they were honest with me. They thought it was a placebo response; the operation wasn’t intended as cure. It was an experimental procedure in the hope of increasing my chances of living away from hospital. This destructive surgery is no longer carried out. 
Since no explanation was forthcoming, I became convinced it was an act of God. What ever caused this light to come on, this ‘reset’, in my thinking, saved my life. Maybe I saved myself. 
It’s a crying shame, though, isn’t it? How on earth had it taken so long to get to this point? I am lucky, I suppose, that the pea-sized lesions that were caused by burning normal brain tissue, haven’t (as yet) caused major long term consequences. These ‘marks’ show up on my brain scan – they are now filled with scar tissue that will never go away. I remain at risk for future seizures as a result.  
I was asked to write a book about the experience and ‘Life After Darkness; a doctor’s journey through severe depression’ was published. My intentions in writing this memoir were good and I was persuaded that by ‘destigmatising’ mental illness others would be helped. At that time I did not understand just how influenced I was, by the paternalism of the psychiatric profession that had treated me. This book I wrote back in 2005 described what happened to me but it does not reflect my current opinion and this is why I have to speak out now. I must put this right. 
I wrote because I had experienced the appalling way the medical world treated people like me — those of us defined by our labels. I became defiant when I told my story; I was not ashamed when I spoke to colleagues, and I taught everyone I knew about how it feels to be one of these stigmatised patients. I didn’t realise then that the stigma, the mark, was the label put on me by the psychiatrists. I thought that it was put there by ‘the others’, the rest of the world,  who marked me and treated me shamefully.  
I still thought I had been helped and that psychiatry would help others too. Eventually.  
I returned to work, back in Emergency Medicine and this caused me to come face to face with reality. I began to see how my recovery was very unusual.  I had survived by the skin of my teeth, despite the treatment not because of it.  
Not long after the book was published, having moved across the country and started work this time in psychiatry myself — a terrible mistake. I found myself going in for ‘round 2’ – I was admitted to the psychiatric ward myself, labelled as a relapse and there I was living in a replay of the nightmare –not quite as prolonged, yet a terrible reminder of the past. Fear took hold of me, and the psychiatrists told me that the only way to avoid another ‘relapse’ was life-long medication with several psychotropic drugs.  
I had fallen into the same trap in deferring to their expert opinions, but fortunately, I became more confident and I forsook the advice that I should never work again. Only this time, I returned to my comfort zone — Emergency Medicine.  
My fear of relapse started to diminish, as I understood that there were perfectly reasonable reasons for having had yet another emotional crisis. It dawned on me that only reason I continued to be compliant with the medication was to treat the anxiety of the psychiatrist who oversaw my care. I was still at work when I started to wean myself off the drugs, one by one. I had no symptoms of relapse but I did suffer withdrawal effects. It took years to become completely drug free. 
The second epiphany may not have been so instantaneous or so dramatic as the first. It was such freedom when I finally discovered that the biomedical model of psychiatry was fundamentally flawed. I tore that ghastly label off myself. However the scars remain. I cannot expunge these DSM-themed psychiatric diagnoses from my medical record, and I cannot undo the harm that has been perpetrated against me and my family.  
In my working life, I have to take considerable care to explain the gaps in my career and have heard more than enough in the way of disparaging comments about me as a result. I have to go over and above, to show that I am neither weak nor vulnerable.  
If I do consult a doctor as a patient with a physical complaint, I have to fight my corner. The label has blinded doctors so that they will prematurely assess my physical symptoms as ‘psychogenic’ or ‘functional’. On one such occasion the delay in diagnosing appendicitis led to sepsis and a belly full of pus.  
Counselling has finally enabled me to process the adversities of my childhood – I fully understand why the resurgence of these memories precipitated the original emotional crisis when I was a young doctor.  
It is not over yet. There is still more work to be done as I come to terms with the trauma inflicted on me for years and years, by my very own medical profession. It is the knowledge that to this day, many others continue to suffer harm as I did, that leads me to speak out once again about what happened.  
Another memoir is on the way: I am re-writing this life story of mine with a new perspective. As I have explored the reasons that led to the breakdowns in later life, I have come to understand how and why I became so susceptible to the control and coercion of others.   
The current climate of fear, the responses of the medical profession and the propagation by the media has convinced many people to believe that they are ill, mentally ill. When in fact their emotional responses are evidence of the opposite. I completely understand why many people are seeking help for ‘mental health problems’ right now; while we complain of being overwhelmed, without enough resources, it is something we, the medical profession, have brought upon ourselves. Sadly, resources that perpetuate these very same myths will not solve these problems.  
I did need help, some of us do. Some of us have lived through terrible things in our lives which have profound repercussions in later life. Yet we survived and some of us can get all the help we need to self-heal, with a good counsellor or therapist. We may not even need such things- there is no one size fits all; our uniqueness means that some of us as children were not suited to the school regimes and rigorous exams. Some of us just need the space to be who we really are in this world.  
This new memoir I am writing — maybe it’s a sequel — will be my attempt to put the record straight. Some may say that what happened to me was a long time ago and it has all changed. It has not. Until the pseudoscience behind the propaganda, (masquerading as research) is exposed, the medical profession will continue to justify the biomedical model of psychiatry. The winners are profit driven pharmaceutical companies, the losers are people like me, who will continue to be labelled. We are distressed people, who turn to doctors for help, become patients and then suffer the consequences of iatrogenic harm. Unless this changes, we alongside our families will continue to be torn apart.  
It makes sense to me to put the matter of my past to rest while I write. I cannot allow my recovery from the horrific experiences I went through as described in my original book, ‘Life After Darkness’, to be used as vindication for the biomedical model of psychiatry. I was supportive of that theory when I wrote. Now I know better. Mental health services harmed me and my family, so until there is a significant change to these practices, I have an obligation to warn others.  
I am one of the lucky ones. I have survived and now I am drug free, better than I have ever been and working as an Emergency Physician. The label has gone but the scars remain and remind me how important it is, to get this right first time round.  
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Cathy is an Emergency Physician living and working in the Southwest of England. As a survivor with lived experience, she has written and spoken extensively around the subject of stigma. However, her writing now reflects the change in her opinion, away from the bio-medical model of psychiatry, since she discovered the myths which saddled her with a DSM diagnosis and the consequent horrors of the treatment she underwent. Cathy continues in her quest to give hope to fellow sufferers to heal from emotional crises. She remains dedicated in her resolve, that everyone is entitled to receive compassionate care, tailored to their individual needs, if they require assistance from healthcare professionals.

1 COMMENT

  1. Thank you Dr. Cathy for this courageous and important post for ourselves and/or our loved ones. It is increasingly revealed by colleagues, that our years of toil and commitment in becoming members of the medical profession afford no protection from psychotropic drug-induced adverse drug reactions and their potential for serial misdiagnosis as MH: ‘Labels For Life’. As these drugs cause changes in feelings, emotions and behaviours, in addition to severe physical ADRs, misinterpretation as emergent additional M.H. diagnoses is understandable. This leads, however, to increased psychotropic drugging and risk of ‘cascade iatrogenesis’. ADRs and possible iatrogenesis are uncomfortable areas for our colleagues to have to consider in future, non- MH health care consultations where denial and rejection may be experienced.
    I look forward to reading your next book, and hope that details may be made available on Mad in UK when it is published.