Misinformation Crusader: Writing About Mental Illness

Join us as Gabe and Dr. Jessi talk about common sources of psychiatric misinformation, the perils of the supplement industry, how mental health and mental illness are often portrayed incorrectly in the popular media, and why she decided to pursue a very specific type of writing career.

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Guest information for ‘Dr. Jessi’ Podcast Episode

Jessica (“Jessi”) Gold, M.D., M.S., is an Assistant Professor in the Department of Psychiatry at Washington University in St Louis School of Medicine, where she works at the Habif Health and Wellness Center, seeing undergraduate and graduate students as patients. She is a graduate of the University of Pennsylvania (B.A. and M.S. in Anthropology) and the Yale School of Medicine (M.D.). She completed her residency training in Adult Psychiatry at Stanford University where she served as chief resident from 2017-2018. 

Dr. Gold is particularly interested in college mental health, women’s mental health and gender equity, physician wellness, medical education, and the overlap between popular media, stigma, and psychiatry. While she has published frequently in the more “traditional” methods of research papers and academic publications, she has also enjoyed teaching about mental health topics and decreasing stigma through writing for popular press outlets. She has been featured in, among others, Self, InStyle, Glamour, and the HuffPost. She can be found on twitter at @drjessigold and at drjessigold.com.

About The Psych Central Podcast Host

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.

Computer Generated Transcript for ‘Dr. Jessi’ Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to the Psych Central Podcast, where each episode features guest experts discussing psychology and mental health in everyday plain language. Here’s your host, Gabe Howard.

Gabe Howard: Welcome to this week’s episode of the Psych Central Podcast and calling into the show today, we have Dr. Jessica Gold. Jessi is an assistant professor in the Department of Psychiatry at Washington University in St. Louis School of Medicine. Jessi, welcome to the show.

Dr. Jessi Gold: Thank you so much for having me.

Gabe Howard: Dr. Gold is particularly interested in college mental health, women’s mental health, and gender equity. She’s also interested in physician wellness, medical education, and the overlap between popular media, stigma, and psychiatry. You’re really writing about a lot of like concepts as it relates to mental health in our society.

Dr. Jessi Gold: Yes, all of the topics that I think people bring into their doctors’ offices or to their psychiatrist or their psychologists. Those are the things that I’m interested in.

Gabe Howard: So let’s kind of start here for a moment, you are a practicing psychiatrist, correct?

Dr. Jessi Gold: Correct, I see patients almost all of my time.

Gabe Howard: So that means when you say these are the things that people are bringing into the psychiatrist’s office, these are the things that people are bringing into your office.

Dr. Jessi Gold: Absolutely. These are the things that we talk about all the time or the things that I feel like I end up repeating a lot or the things that I hear other people talking about, what their experiences with patients or on social media topics that are coming up in the news or topics that are coming up in movies or television.

Gabe Howard: How does something happening in pop culture or the news impact your ability to help patients or the patient’s ability to connect with you?

Dr. Jessi Gold: There are lots of ways, actually. So I would say the one way would be that if what they heard on the news would make them stigmatize mental health in some way or think that something was wrong with them because they had mental illness. That might mean that they don’t get help when they need it. That might mean that they avoid going to get help until they’re really quite sick and they’re not coming in the preventive stage of care. And we often say when you’re actually suicidal or when you’re not getting up out of bed or you’re not eating, you’re not sleeping, those sorts of things. If you’re waiting till then, sometimes there are reasons that that’s the case. But if it’s because you read something on the news that told you you don’t actually have a problem or made you feel like you should be ashamed to have that problem, it very well could impact your care, your day to day, that’s one way. Another way would be if they said something on the news about a particular treatment or a particular way of dealing with a problem. And sometimes those are evidence based.

Dr. Jessi Gold: And that’s great. And sometimes they’re not. And I think that people will come in to their doctors’ offices or talk to their friends or family or talk to someone on social media or offline about these kinds of treatments that are mentioned. And I think that’s another way it can impact your day-to-day practice. So you should know about the things that people are talking about and be able to comment on them, be able to say that that isn’t true or won’t work because of an actual reason. I don’t really see that as a patient’s fault or a family member’s fault. I think that if we’re advertising directly to patients, as some pharmaceutical companies do, or we’re talking about treatments in the news or wellness products in the news, that’s what people are reading and seeing. So you can’t really fault them for having a comment or having a feeling about what they see. It’s my job to be able to say this is not true because or this won’t help you because or this will help you because. And sometimes they have really great ideas, frankly.

Gabe Howard: That’s actually a really great point. One of the things that you said is that sometimes they come in with the correct information. They have information that they learned from a credible source. So I think we can all understand how empowering that can be and how it can help your job. What about when they come in with the, you know, the get-well-quick scheme, as I like to call them, when they, you know, I watched a YouTube video and it said that if I do lavender oil on the back of my ear, it will cure my voices. And I don’t understand why you’re hiding this from me. How do you handle that?

Dr. Jessi Gold: It’s really hard, you know, because I think if you read things and you see things, it’s easy to believe them. And if you want to believe something, because you’ve had a lot of things wrong with you and nobody’s able to tell you what’s wrong with you, which happens a lot with chronic pain, for example, or you don’t necessarily like the diagnosis that you’ve been given or you think it means something you don’t want it to mean. All of these are vulnerabilities that are very easily preyed upon by these kind of products or the wellness industry. And basically what happens in those kind of conversations is you just have to level with people and try to give them the best information that you have and try to make a case for why you don’t think it’s the best thing for them and why you think something else would be. It doesn’t always work. And I definitely think that there are times where it’s kind of frustrating for both parties. You know, a lot of supplements, for example, do have negative impacts on other pharmaceuticals you could be taking or might have side effects that interfere with mental health in general or could have side effects of something like suicidality.

Dr. Jessi Gold: And so understanding those are really important to be able to convey to the patient. But also, if you still stay on them and I’m trying to prescribe a medication, I think it can be pretty hard as a prescriber to do that ethically and feel good about someone staying on something that, you know, is really bad for them. The problem with a lot of these things is we don’t actually know what’s good or bad about them. Most of the time it’s kind of neutral and you’re just spending a lot of money on something that’s not doing anything. And I think that’s a whole other conversation. But when you have those conversations with people, again, it’s just sort of like this is what we know. This is what we don’t know. I’m trying the best I can to help you. And this is what I think would work. And I hear why you think this should work or why you read that this could work. And I’ll read more about that to see what there is about that if I don’t know anything about it. But for now, this is my recommendation.

Gabe Howard: It’s interesting what you said there, and I agree with you, I don’t want to fall down the rabbit hole on this one, but you said they’re spending a lot of money on these supplements or alternative treatments. And that’s one of the things that I hear out there a lot. We can’t trust the pharmaceutical companies because they’re just in it for the money. And yet the supplement business, the alternative medical business is a multi-billion dollar industry. And yet somehow it’s managed to kind of create this idea that, oh, no, they’re in it to help you. Unlike regulated industries. And I’m sure we could do a whole show on that. But how does it make you feel knowing that they’re dissing a multi-billion dollar industry in favor of another multi-billion dollar industry and they’re sitting in front of you and you seem to have the least amount of clout in the room sometimes?

Dr. Jessi Gold: Frustrated is the first word that comes to my mind. I think that there are plenty of problems with the pharmaceutical industry. Don’t get me wrong. And I think that one of the things that’s not a problem is that they do evidence-based studies. Sure, like some of the studies are probably skewed and they are presenting a lot of the better evidence, but they have to go through FDA approval. And a lot of these supplements, a lot of the things that you could buy, they have no regulation process. And so not only are they costing money, we can’t even say that. Like if I picked this pill out of this bottle, it will be the exact same as that same pill in a different bottle. They’re just not regulated. Whereas if you took any of your daily medication, they should all have the exact same dose of that medication in it. Right? That’s how we regulate it. So I think that there obviously are problems with, as they call it, Big Pharma. But there are plenty of problems with the wellness industry. And I think I sit in this intersection where both prey on my patients. And so I’m well aware of those and I see the direct-to-consumer marketing of Big Pharma. But then I also see celebrities talking about wellness products that cure your mental health or help with anxiety. And I just get frustrated. I wish that there was a better way to help people or help people see that there are great things about medication, even if maybe the way that it gets to you feels frustrating.

Gabe Howard: I think that everything that you said was fair, that just because something has a problem doesn’t mean that you have to throw all of it away. I always use the example that, you know, look, as much as I love my wife, she’s not perfect. She’s my wife. I picked her from all of my options. And even I can admit as much as I love her, that she has her flaws. But overall, she’s a great wife. But we look at corporations, at industry, at companies, and we somehow are only willing to accept perfection. We don’t have this attitude in other areas, but we sort of have it in our mental health care and probably our medical care. This just happens to be a mental health show. Can you kind of speak on that for a moment? Because there’s nothing that’s perfect, including if we’re being honest, psychiatrists.

Dr. Jessi Gold: I’m absolutely not perfect. I think that that’s also a fault of sort of medicine and how we train and how medicine has been perceived throughout history. I think it’s also why so many medical providers that have medical illnesses or mental illnesses have trouble admitting them. I think if we’re supposed to be perfect, how can we also have depression or how can we also be burned out? Right? I mean, there’s a high rate of mental illness in physicians for a reason. And we don’t get treatment. Physicians in general tend to treat themselves instead of going to get help. So I think it has a ton of downstream effects. I think it’s humble and true to say you don’t know and you don’t know. And there are lots of things we don’t know. I also think it’s important to say what things we do know. And when you’re explaining like, let’s say a medication to someone, being able to really clearly state, like what evidence we do have and what we know are some of the side effects and what we don’t know is also relevant. And I think that saying you don’t know feels uncomfortable and might even feel uncomfortable to be heard by a patient when a doctor says it. But it’s true a lot of the time. We’re working on a lot of this stuff. A lot of things change at a pace that’s much quicker than research and definitely much quicker than FDA approval of any sort of medication or new treatment. So I think the idea of perfection definitely has effects on not just the doctor-patient relationship, but I think on physicians and other health providers themselves.

Gabe Howard: We’re going to step away to hear from our sponsor and we will be right back.

Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Gabe Howard: We are back talking with psychiatrist and popular media writer, Dr. Jessica Gold. Your writing has been featured in SELF, InStyle, Glamour, The Huffington Post, all kinds of places online. Let’s pick on your fellow psychiatrist for a moment. Why are you drawn to this type of public outreach in a way that your colleagues are not?

Dr. Jessi Gold: That’s a really good question. I think that when I was in training, it wasn’t necessarily frowned upon, but I wouldn’t say was encouraged to do this sort of writing. You know, if you get trained in an academic medical center, writing research papers, writing for our own peers is very valued. And so you spend a lot of time doing that. So we spend a lot of time doing that, and it’s encouraged and supported, there’s a lot less encouragement on the popular press side of writing. We also don’t have as much training on it. Nobody’s really teaching us how to write. One reason why other providers are not doing it is they might not think they’re a good writer or they might not think that that’s something they know how to do. Because academic writing is very, very different than popular press writing. It’s sort of like when you go to the doctor and they’re explaining things and they’re only using big jargon words. And you’re really confused versus how I’m talking to you now. They’re very different communication styles. And then I think for psychiatrists in particular, we’ve always been taught that we’re not supposed to be kind of taking up space. So there’s this blank slate argument. Psychiatry and psychology started with psychoanalysts where basically we are there to project you on to you and not really project our own opinions and feelings into the room. And if we are on TV or writing for the popular press or talking on a podcast, we’re talking as ourselves. And it gives a lot of information about me. I try not to give all the information about me for the same reason. But I think you still learn a lot about my opinions and my thoughts and how I view things. And it’s a lot more vulnerable that way. And patients definitely read it. So I think it definitely changes the dynamic in a physician-patient relationship or therapist-patient relationship. If you’re doing a lot of these sorts of things, that is maybe a particular reason my psychiatrist might feel less excited about it.

Gabe Howard: As somebody who lives with bipolar disorder, I’m really excited to see somebody in your position writing about the reality of it, because I think that there is a lot of disconnect between patients and doctors. And I really do feel that your articles help close that gap. You know, one of the… the stigma surrounding psychiatry is that psychiatrists are as crazy as their patients. And that’s sort of a trope. You see it in movies, you see it on television, but it isn’t like that. And how does society perceiving all psychiatrists as, you know, just as mentally ill as their patients prevent people from getting treatment?

Dr. Jessi Gold: I hope that that’s something that’s going away with time. I think that a lot of the images on TV and movies are made to be entertainment and not based in truth. I’m hoping also that will shift over time as people realize that those portrayals actually do have effects in what people are doing and how people are getting care, how people are perceiving physicians. There are not that many psychiatrists or mental health providers on TV and they tend to come in and very random occasions to do like couples therapy or just kind of scoot in or there’s always like one of the tropes that comes up a lot is they sleep with their patients, which is, you know, against all of our ethical boundaries and guidelines in so many ways. So I think that it’s a gross misperception. However, we are human. Right? And so one in four people have mental illness. So there are a lot of psychiatrists. Somebody is going to have mental illness. I also think we’re just fascinated innately by the human condition. So we went into a field where our job is to listen and care and know what’s going on in your life and your life matters, that you’re not just a symptom. And I think being innately interested in that might mean that we’re also curious about ourselves. But we are all human and most humans do have struggles.

Gabe Howard: I love your general attitude of, you know, look, I don’t know everything, but, hey, at least I’m willing to talk about it and engage people. I love your vibe so much.

Dr. Jessi Gold: Thank you.

Gabe Howard: Sometimes doctors believe that they know everything. And I think that’s where people get in trouble. And I don’t know if it’s extra true in the mental health space, but I talked to a lot of people, a lot of mental health patients that are just like I told my doctor that this was unacceptable. And my doctor said, well, you’re either gonna kill yourself or you’re gonna do what I say. And I’m like, oh, my God, that’s so horrible. You know, talk about like lack of bedside manner. Right? It’s scary. When we talk about your writing, Jessi. Who are you considering your target audience?

Dr. Jessi Gold: I would like to say every one. I particularly pick places that I am aiming to talk to my patients, my patients’ families, the general population that have these misconceptions about mental health. I don’t love writing for a medical audience. I do research because that’s part of my job. I have written for psychiatric publications where it comes up, but I really do love aiming to write for just kind of everyone. And that means that my pieces have gotten into a lot of what we would call, like traditionally women’s magazines. And I don’t know if that’s just because of who I know or how I’ve gotten connected. But it’s not that I’m meaning to exclude men by any means, because men obviously also have mental health problems and have rates of mental illness at high rates as well. But I really hope that everyone reads the kinds of stuff that I’m writing. And a lot of what I’m writing is inspired by things that I’m talking about with patients and things that come up. And so if they’re coming up with me, they’re probably coming up with other people. So I’m hoping that that makes it exciting for people to read or they find it useful. I wrote a piece about questions that you should ask your therapist, and I thought that that would be something that someone could read before they went to a therapist and they could carry it with them to the therapist or think about these things before. And they’re just like things that maybe you hadn’t thought about before. Like, would you want to say hi to your therapist if you saw them in the street? That kind of thing. And I think they’re just questions that come up with me, and I hope other people are excited and interested in them. And so I write them.

Gabe Howard: Jessi, we’re nearing the end of the show. I am also a writer, so the question that I always like to be asked whenever I give an interview is what’s my favorite article? So I pose to you: What is your favorite piece? What is your favorite article that you have ever written?

Dr. Jessi Gold: It’s a very hard question for me, actually, because I like different things for different reasons. I think more recently, one of the pieces I’m really excited that I was able to write is I wrote this piece for InStyle about what it means to “check in” for mental health. I think that comes up a lot specifically with celebrities. And it was inspired by Britney Spears, actually. And these headlines that weren’t really making sense about if she was in a hospital and where she was. And I got to write a piece for InStyle that really looked at what does it mean to be in a facility? What does it look like day to day? What are the different types of facilities? Because I think also when you say checking in, does that mean somebody is in an involuntary ward? Does that mean you’re in residential treatment? There’s just so many options. And I think it was really nice of the editor. I work a lot with that editor writing pieces that really take things that happen in entertainment or take things that happen in popular press and inform based on them. And that was a really fun piece to do because it got to get into like the nitty gritty, important stuff for patients. But it was grounded in something that people were reading about just as a headline and actually was inspired because she was curious and she didn’t know the answer. And I really liked that, which is like editors of these places that could be traditionally just talking about fashion being like, hey, like this comes up a lot that I don’t know what this means and I know someone who can help me know what this means and will you please write it? And I was really excited to do that. So that’s probably if I was to pick a piece right now, I’m excited about that one.

Gabe Howard: Jessi, where can our listeners find you if they want to read more and learn more about you and drop all your social media links as well.

Dr. Jessi Gold: The easiest place to find me is I’m very active on Twitter, and that for me is @DrJessiGold. I spell Jessi J E S S I. So @DrJessiGold. Gold is just like the color of the metal or whatever you think about when you think of the word gold. I love Twitter. It’s a good way of reaching out to people and connecting. It’s one of my favorite forms of advocacy. So it’s easy to find me on there. I also have a website which is just DrJessiGold.com and there you will be able to find a lot of the pieces I’ve written. There’s a link to most of them. You can always look up my name and things like SELF magazine or InStyle and find my stuff pretty quickly too.

Gabe Howard: Jessi, that is awesome. Thank you so much for being on the show, we really appreciated having you.

Dr. Jessi Gold: Thank you so much for having me.

Gabe Howard: And thank you, everybody, for tuning in. I’d like to ask you a personal favor right now. Wherever you downloaded this podcast, if you could give it the appropriate amount of stars, we always love the most amount of stars and write a review. Use your words, tell other people why they should listen. Share on social media. E-mail it to a friend. There’s no reason that a podcast about mental health should be this hidden. And you can get one week of free, convenient, affordable, private online counseling anytime, anywhere simply by visiting BetterHelp.com/PsychCentral. We will see everybody next week.

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