Reflections On Medicine, Shame And Stigma

As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.

Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.

My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.

I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.

Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.

Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.


Ken Duckworth is medical director at NAMI.

How To Have A Healthy Relationship With Social Media

Social media has allowed society to become more connected than ever. Over three billion people around the world use social media to engage with others, access the news and share information. In the U.S. alone, seven out of ten people are active social media users.

Some would argue that social media is inherently bad for our health. Recent research explores the negative implications of social media, including sleep issues, an overall increase in stress and a rise in mental health conditions and addiction to technology. There are also concerns about cyberbullying and youth and teen safety online. Fortunately, tech companies are proactively addressing these types of concerns. For example, the recently released Parent’s Guide to Instagram helps parents who are “raising the first generation of digital natives, for whom the online world is just as important as the offline world.”

On the other hand, there are many benefits to social media. Young people today consider social media as platforms for sharing their voice and finding a community of like-minded peers. And users of all generations understand that with social media, you can celebrate milestones or reconnect with old friends and relatives.

Regardless of what type of impact we believe these digital platforms can have on us, we must be intentional in how we use social media. For example, as NAMI’s social media manager, I use social media as a tool to spread mental health awareness. Through my experience, I’ve learned several tips and tricks for having a healthy relationship with social media. Here are some you might find helpful.

Unfollow Unhealthy Accounts

It’s important to remember that, often, the images and stories on social media aren’t reflective of real life. Whether you follow friends, influencers, businesses or organizations, social media feeds are filled with carefully crafted, curated posts. Consider the following: Does your feed leave you feeling overwhelmed or less-than? Do you constantly compare your experiences with others? If yes—and you notice an overall decrease in your happiness, self-esteem and life satisfaction, it’s time to make a change. Put an end to the negativity by reviewing the accounts you follow—unfollow, block or delete accounts that don’t bring positivity, motivation or inspiration into your life.

Support And Connect With Others

There are many people you can connect with through social media, even if they’re on the other side of the planet. And that’s a good thing. However, if the interactions you’re having leave you feeling isolated or upset, you should reevaluate why you use social media. Do you want to engage with others who share your interests? If so, search for digital communities of people who you have something in common with. From there, you can be more selective with who you connect and engage with.

Take Note Of What You Share

These days, it can be challenging to determine reputable sources of news and information. That’s why it’s important to play a conscious role before sharing something you see online with your friends or followers. Think about whether the content—be it an article or video—is helpful or harmful to others. Also consider if it truly provides knowledge worth sharing. If it doesn’t contribute something positive to the digital world, it may not be worth sharing on your social media account.

Reduce Your Screen Time

Smartphones are quite everywhere these days. In any public setting, you’ve likely noticed others with their eyes glued to their phones. In fact, recent studies reveal that people spend an average of over two hours a day on social media. If you’re concerned you may be spending too much time social media, try adopting healthier habits. Start by tracking the time you spend on social media; if you’re on Facebook or Instagram, look out for the new tool that helps users manage time spent on their accounts. When you limit your screen time, you’re creating more time for enriching, real-world experiences.

Take A Break

Completely stepping back from social media can be hard, but it’s a good way to help you reconnect to reality. Log out from your accounts for a full day, a week or even a month. Have a friend change your password so you don’t feel tempted to log back in to your account. Then, take notice of how you spend your time. Perhaps you rediscover an old hobby or sport. Or maybe you’re able to schedule more quality time for your family or friends. Either way, it’s more exciting to live life as it’s happening, as opposed to “living” through a screen.

Rather than thinking of social media as something that only hurts our health, we should reevaluate when and how we use our accounts. Social media platforms can be used for good—it all depends on whether you choose to use it for good.


Ryann Tanap is manager of social media and digital assets at NAMI.

5 Common Myths About Suicide Debunked

Suicide affects all people. Within the past year, about 41,000 individuals died by suicide, 1.3 million adults have attempted suicide, 2.7 million adults have had a plan to attempt suicide and 9.3 million adults have had suicidal thoughts.

Unfortunately, our society often paints suicide the way they would a prison sentence—a permanent situation that brands an individual. However, suicidal ideation is not a brand or a label, it is a sign that an individual is suffering deeply and must seek treatment. And it is falsehoods like these that can prevent people from getting the help they need to get better.

Debunking the common myths associated with suicide can help society realize the importance of helping others seek treatment and show individuals the importance of addressing their mental health challenges.

Here are some of the most common myths and facts about suicide.

Myth: Suicide only affects individuals with a mental health condition.

Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.

Myth: Once an individual is suicidal, he or she will always remain suicidal.

Fact: Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help to reduce symptoms.

The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.

Myth: Most suicides happen suddenly without warning.

Fact: Warning signs—verbally or behaviorally—precede most suicides. Therefore, it’s important to learn and understand the warnings signs associated with suicide. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what’s going on, which is how it may seem like the suicide was sudden or without warning.

Myth: People who die by suicide are selfish and take the easy way out.

Fact: Typically, people do not die by suicide because they do not want to live—people die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, “thinking of themselves,” but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.

Myth: Talking about suicide will lead to and encourage suicide.

Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.

Debunking these common myths about suicide can hopefully allow individuals to look at suicide from a different angle—one of understanding and compassion for an individual who is internally struggling. Maybe they are struggling with a mental illness or maybe they are under extreme pressure and do not have healthy coping skills or a strong support system.

As a society, we should not be afraid to speak up about suicide, to speak up about mental illness or to seek out treatment for an individual who is in need. Eliminating the stigma starts by understanding why suicide occurs and advocating for mental health awareness within our communities. There are suicide hotlines, mental health support groups, online community resources and many mental health professionals who can help any individual who is struggling with unhealthy thoughts and emotions.


Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women’s blog. To read more of Dr. Fuller’s work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds.