I just recently heard a statistic: 25 percent of veterinarians were seriously considering retiring or leaving the field, and 33 percent would not recommend veterinary medicine as a career. We also know veterinarians are at a much higher risk of suicide as compared to other health professionals.
We all know, “First, Do No Harm” is part of the Hippocratic Oath, but I would like to take some literary license and expand this to, “First, Do No Harm To Thyself.”
All in the family
I suffer from hereditary mental illness (depression for sure, probably more) and only recently took the giant step to get psychiatric help. I did not have my first major depressive episode until I was in my late 40s, and with help from my local family physician, was able to find the right antidepressant in the right dose for me. The venlafaxine molecule (common brand name Effexor) was a miracle to me. Emerging from the shadows and moving with the speed of a sloth, I got back to my sunny, optimistic, can-do self. Laughing again.
I was only on the antidepressant for less than six months the first time when I successfully tapered off and remained unmedicated for about five years. When I relapsed into depression the second time about five years later, I knew studies showed if you went off antidepressants a second time, you had an almost 90 percent chance of relapse. I decided with the advice of my local physician and my sister, who is an MD, to just stay on this lifesaving drug for the rest of my life.
I do not say “lifesaving” casually. As I have written before, my dad’s father, brother, and sister killed themselves. Dad, too, took his life, mouthing a 16-gauge shotgun just after his 80th birthday. I know my grandfather, uncle, and aunt did not have a diagnosis of mental illness and never sought treatment other than from Jack. Jack Daniels.
My father, Bob, did get an accurate diagnosis and got treatment. He was diagnosed bipolar and also alcoholic (he went to AA and was off the bottle, off and on). His treatment ranged from electroshock, to lithium (which proved miraculous at the time), to eventually Prozac. He never got therapy or counseling other than from a friendly pastor or two.
Recently, the generic Effexor I have been on was not enough to keep me from falling into a deep depression. Just as COVID started, I had my first really suicidal thought, which terrified me. I was going to drive out onto a frozen Northern Idaho lake and just sink.
But instead of turning to the left as I drove home, across the railroad tracks out onto frozen Lake Cocolalla, I pulled over and called my family doctor. He doubled my dose of Effexor on the spot. In the coming months it helped, a little, but I still found myself diminished, with low energy and decreased joy. Molehills became mountains, and worst of all for me, I procrastinated. Those who have known me for decades know this is the opposite of my normal: high-energy, positive, proactive, deadline-driven, with can-do-ism coursing through my veins.
Everything kind of came to a head over this past Thanksgiving. My precious daughter, Mikkel, and granddaughter, Reagan, were at our Almost Heaven Ranch. This was the first Thanksgiving in 25 years my wife Teresa’s mother, Valdie, and brother, Rockey, were not at our table. They both died of COVID.
Sitting at the table, talking turkey over turkey, a roaring fire in the fireplace, light flickering off of the walls of our log home, presents already under the Christmas tree, my heart-dog QT Pi in my lap, looking at my beloved wife of 43 years, I knew I was blessed beyond measure. I still felt like God had always played favorites with me. While I knew how happy I should be, I could see it, I had been there before, but I just could not get there. It was like a ladder where happiness is at the top and the upper third of the rungs were missing. How would I get there?
I know there are rungs you can add yourself through prayer, medication, exercise, getting away from the desk and outside, gratitude journals, serving others. I already do most of those and this got me partway to my normal. But they were not enough to get me to where I needed to be the best husband, father, friend, neighbor, coworker, leader, you name it. To be my best for me.
Upon the strong urging of my family, friends, and my general practitioner, I decided to get a diagnosis from a trained psychiatrist and therapy.
The first meeting with the psychiatrist was the hardest 90 minutes of my life. I’m not kidding. A personal experience more uncomfortable than being on the witness stand in a trial, more frightening than being lost in a dangerous city, more exhausting than stacking hay for 10 hours as a young farm boy. The session ended with me physically and emotionally exhausted. Why? Because I needed to find out who the real Marty Becker is, was, will be.
There’s a saying, “When two people meet, there are really six people present; the person you think you are, the person the other person thinks you are, and the person you really are.” Speaking with the shrink, I think I must have met a dozen Marty Beckers, and it was just the first session!
I, like most of you, have lived many lives. First, by age: newborn, infant, toddler, child, preteen, teen, young adult, adult, and, finally, senior. Education wise: preschool, kindergarten, elementary, junior high, high school, college, and, for those of us veterinarians, post-graduate. For family: single, dating, marriage or partnership, no children, with children, no children living at home again, grandchildren, great-grandchildren, and, for some, great-great-grandchildren. Economically: allowance, first jobs to make your own money, better jobs allowing you to make ends meet as you make a life (vehicles, home, etc.), making enough money to start saving, retirement.
Mental illness follows a different path to diagnosis. There are no blood tests that point to depression, bipolar disorder, or schizophrenia. No imaging, CT scan, or MRI to find mental health problems other than the rare instances where a brain tumor, pork tapeworm, or Toxoplasma gondii affect the brain. The vast majority of mental health problems are caused by hereditary and environmental issues.
The therapist talked about the process of finding a diagnosis as peeling off the layers of one’s life, along with forensics, such as what other family members have what mental health conditions, along with detailed interviews and questionnaires asking about specific traits or incidents.
You know how we often say in vet med, “Diagnose before you treat”? It’s the same thing with mental health issues.
In follow-up therapy sessions, we keep digging deeper and deeper, at almost a self-directed pace, but not like I’m off the leash and not brought back on topic from time to time, or challenged. We both seek the truth, my truth, in finding out who Marty Becker was, is, and will be. With a proper diagnosis and treatment—which will almost assuredly involve drugs and therapy—I want to be the best version of myself, which will, in turn, let me be the best husband, father, grandfather, friend, neighbor, veterinarian, colleague, on and on.
For me, I know vulnerability shows strength not weakness. As such, I have kept sharing my mental health journey with you, my colleagues, coworkers in the same industry, and friends to help to destigmatize mental health struggles. So many great organizations, such as Not One More Vet (NOMV), are also leading the pioneering mental health solutions.
I can tell you as if I’m looking at you eye-to-eye, do not suffer in silence and put you and those you care about at risk. Talk with a professional about your struggles. Explore therapy (it is so easy to do online now). Working together, you will find the right treatment and life-changes that can have you up to the top of the ladder, looking out over the sunshine side of the mountain once again.
Marty Becker, DVM, writes every other month for Veterinary Practice News. He is a Sandpoint, Idaho, practitioner and founder of the Fear Free initiative. For more information about Fear Free or to register for certification, go to fearfreepets.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.