Anna Mehler Paperny: Hello I Want To Die Please Fix Me
Selected Excerpts
Know Thine Enemy
“While pathological despair is hardly new, “depression” as a mood disorder really emerged in the middle decades of the twentieth century, as psychiatry sough to cast off both its asylum baggage and its pseudoscientific reputation: psychiatrists were to be consider “real” doctors, treating relatively “normal” people — not confined inside mental hospitals but walking around in the world.”
Certifiable
“Here again, my bias shows. Having something as basic as the right to confidential health information trampled is intensely disempowering at a particularly disempowered moment in your life. During my second psych-ward sojourn, my parents met my psychiatrist. Fine. They came back to visit me in my curtained-off bedspace saying the nice doctor had told them my next treatment option could well be electroconvulsive therapy. I was livid. He’d never mentioned that to me.”
Discussion Questions
What stands out in reading the first excerpt? Have you noticed that major depressive disorder has become “easy to discount and easy to conflate with a ubiquitous human emotion”, like the author has?
How might we decrease stigma and raise awareness of mental illnesses like Major Depressive Disorder without conflating them as equivalent to normal emotions or overpathologizing?
What resonates with you in the second excerpt Certifiable? What are your thoughts on "clinical compassion" in psychiatry as compared to other areas of medicine?
Paperny makes the argument that more voluntary care should be prioritized in psychiatry. What would this look like? Is this possible in our current system?
What is one change to the mental health system you would make to reconcile the harmful past of psychiatry and/or to move it towards a better future? Why?
Reflections from #MedHumChat
“Patient’s problem lists may have “depression” listed on it and it’s easy to overlook. But when it states “major depression” that stands out more. Something to think about.” —@shivanijanimd
“I think part of the problem is our inaccurate & oversimplified distinguishing of "mind" from "body" and anatomic "structural" disease from "functional disease." I try to challenge these dichotomies with patients.”—@SarahMatMDMPH
“As I read, I thought about how rare it is for psychiatrists to have the lived experience of serious mental illness and how this means we must have great humility about the limits of our ability to understand those experiences as we strive to be compassionate.” —@ibald_WIN
“Meet patients with a presumption of competence. Believe patients. Center consent. Make sure diagnostic overshadowing doesn't result in missed differential or additional diagnoses. Don't deny patients diagnostic workup.” —OdyO11
About this #MedHumChat
These two excerpts from Anna Mehler Paperny’s book Hello I Want To Die Please Fix Me were the center of a #MedHumChat discussion on February 3, 2021 about The Future of Mental Health Care.
The pieces for this chat as well as the accompanying discussion questions were curated by Maggie Hulbert (@MaggieHulbert) and Andrew Lee (@Andrewmklee_).
About the Author
Anna Mehler Paperny (@amp6) is an author and reporter for Reuters. Her book Hello I Want To Die Please Fix Me was a national bestseller and a finalist for the Hilary Weston Writers’ Trust Prize for Nonfiction.