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“Was I that different? I had severe anxiety necessitating medication, compounded by stress, my own narcissistic tendencies, and a series of life choices—but Jason had something much worse. It all gave me pause. I was now twenty-four, just barely older than Jason when the committee took residence. Would I soon begin hearing voices as well?
I supposed that beginning the long and arduous road of medical education while having an infant at home with a lonely wife in a new place more than a thousand miles from our family counted as enough of a stressful event to trigger whatever may lay dormant in my brain.”
Kyle Bradford Jones is a family physician and can be reached on Twitter @kbjones11.
He shares his story and discusses his book, Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Kyle Bradford Jones. He’s a family physician, and he’s the author of the book “Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.” He contributed this excerpt to KevinMD earlier this year, “How your mind can turn against you.” Kyle, welcome to the show.
Kyle Bradford Jones: Hey, thanks. I’m glad to be here.
Kevin Pho: So we’ll get into your book in a little bit, but first off, tell me your story and your journey to where you are today.
Kyle Bradford Jones: Sure. So right now I am an associate professor at the University of Utah School of Medicine in family and preventive medicine, and I joined the faculty when I finished residency, about eight years ago now. With the book and discussing my own mental illness and difficulties, in, I think it was 2014, I was blogging regularly for the American Academy of Family Physicians, and I shared a post which was the first time I had come out publicly with struggling with depression and anxiety. It was a very difficult step for me, as you can imagine, but the feedback was incredible, because it was one of those things where people were saying, “Boy, I feel so much better about what I experienced, because someone else experienced that as well.” And so that was a big thing for me.
I was diagnosed with anxiety as an undergrad almost 20 years ago, and that continued on throughout medical school and residency, but I also developed a severe depression during residency from the stress and a lot of the difficulties and interactions that we all have in medicine. And so I’ve been on numerous different medications and been through many therapists and whatnot. The nice thing is I’ve come to the place where I need to be. I feel as though I’m in an appropriate place in my life. I’m feeling good. I’m functioning and successful in every different way you could define that. And that’s one thing I try to share a lot with people, that there is hope and it’s OK to struggle.
Kevin Pho: I think the topic of mental illness and medicine is so important. We need to destigmatize it, because there are so many medical students, residents, and physicians who are going through the same thing that you went through, suffering from mental illness like anxiety and depression. I was wondering if you could share some of the challenges that you faced going through medical training with anxiety and depression.
Kyle Bradford Jones: It was difficult in that sometimes it was so overwhelming that I couldn’t function. Some of the anxiety came because I am kind of a perfectionist and very driven, and of course, like many of us, you have to do that in order to get into medical school, and so many of us share those personality traits, but it took it to a full extreme. And so there were times where I would have panic attacks where I was unable to properly function.
Especially in residency, when the depression came on, there were a number of things that I really struggled with, and it made it that much harder to learn how to be a good physician, because I was just trying to survive. And that’s something that, again, like you say, so many of us go through and experience, and it’s such a common thing. And like you say, the efforts to destigmatize mental illness among all health care professionals are really a very important thing for us to function as best we can and best take care of patients.
Kevin Pho: Going through medical training is difficult enough, and I can’t imagine going through it also fighting anxiety and depression as well. What kind of support services did you have going through medical school, going through residency, or even as an attending?
Kyle Bradford Jones: So certainly family. I have been married throughout that entire journey. I have four kids now. My first child was born in my undergraduate years, so I had kids all throughout that, which sometimes made it more difficult, but other times really provided that complete release and separation from my studies and training. If you have a small child and you come home after a tough day, all of a sudden you’re in their world, and they don’t care what happened anywhere else. It’s “Daddy’s home,” and you’re right there. Having that ability to completely disconnect and focus on someone else really was a big help.
Also, like I mentioned earlier, I’ve been through multiple therapists. I’ve had a tough time connecting with some of them, and now I have a good therapist that is very helpful for me. I did have to go through some different medications to find a good fit for me, but now I have. But also, even just having the courage to talk about it has made it so much easier to deal with, and not being afraid that that means that I’m a terrible physician or I can’t accomplish what I need to or care for my patients, but just being open with it and being able to talk with people really has provided almost a huge relief, that I don’t have to just hold it all inside. And that’s been a huge help as well.
Kevin Pho: Now, what was that point that made you want to share your story? Because talking about depression and anxiety, especially as a medical student or as a resident, isn’t often encouraged. So what made you decide to be open and share your story?
Kyle Bradford Jones: I think part of it was that I recognized that I wasn’t the only one, that there were multiple of us, both in medical school and residency and even once becoming an attending, that struggled with that. As a resident, there would be a number of my resident colleagues who would just break down in the middle of the day and weep. That particular thing never happened to me, but I knew that we were experiencing similar things. And so I thought, “I know I’m not the only one, and if I can take this step, not only will it help me in dealing with my own issues, but hopefully it will help others to feel more comfortable dealing with theirs.”
Kevin Pho: Now, I think, as we both said before, there are so many medical students and residents and physicians going through these same issues. Do you have any advice for them as they progress through their medical training?
Kyle Bradford Jones: Be kind to yourself. A lot of times we put so much more pressure on ourselves than others put on us, and that is just so detrimental to us. And so if we can allow ourselves some grace to say, “It’s OK if I make a mistake. I just learn from it and I move forward. Everybody makes a mistake. It’s not just me,” I really think that’s the first step.
Now, if you are getting to the point where this really is a mental illness or a clinical diagnosis, as opposed to burnout or other feelings that are more specific to the situation, then absolutely, please go get some help. Talk to a therapist. Don’t be afraid to try some medication if you need to. But it doesn’t mean that you are less of a person or less of a physician.
Kevin Pho: And for those medical students who may be going through this, what are some of the signs and symptoms that would make them want to take that next step and perhaps seek help?
Kyle Bradford Jones: So for me, it all came to a head when I had a panic attack. I always knew I had an anxious personality, but didn’t really think it was anything severe. But when I had the panic attack, I thought I was having a heart attack. I didn’t recognize it for what it was. And so, first of all, understand that panic attacks are very common among medical students and residents, where we are just so overwhelmed that we can’t take it anymore, and our body just goes into that mode of dispelling some of this anxiety.
But also, being unable to focus at all really is a big part of it, too. When we are medical students, we have to study for hours on end, and there were times where I’d be studying for hours and I’d realize I hadn’t learned anything, because I couldn’t focus well enough and nothing was sticking. A lot of that was my anxiety and not being able to really put myself in the appropriate place to study and to learn.
Also, as we all know, sleep is hugely important for your mood and for our ability to function. So if you are struggling with sleep, that’s probably one of the first places you need to start. Those are just a few. Obviously, there are a whole bunch of others that we need to watch out for, but just be self-aware, be kind to yourself, and recognize that there may be something more going on keeping you from being your best self.
Kevin Pho: Now let’s talk about this issue from another perspective. You’re a medical educator. What can we do from a medical school standpoint or from a residency standpoint to help address this issue?
Kyle Bradford Jones: It’s tough, because there are obviously both systemic issues to address and also personal issues to address. So many of the systemic issues are intertwined with the other frustrations that all of us have as physicians: so much documentation, prior authorization, not having as much autonomy as we feel like we should in order to care for our patients. That is a big thing that’s tied into it, and residents feel that a lot as well.
One thing that I’ve done as an attending is, when I’m working with residents, every once in a while I’ll pull one of them aside and just say, “How is your well-being right now?” Sometimes they’re like, “No, actually, I’m doing pretty good,” or, “This is what I’ve been doing to help myself.” And sometimes even just allowing them that space to talk about what’s been going on inside them, and asking that in a sincere way, “How are you doing?” really provides a huge relief and almost opens up the pressure valve. They feel safe, and they can talk about it. Even just little things like that really do make a big difference, and knowing that you’re supported and that, again, you’re not alone. You’re not the only one experiencing this.
Kevin Pho: We’re talking to Kyle Bradford Jones. He’s a family physician, and he’s the author of the book “Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.” Kyle, what has the reaction to your memoir been?
Kyle Bradford Jones: It’s been very positive. I’ve had a lot of residents and medical students already come to me and say, “This has been so helpful, and I am seeking some help because of it and recognizing that I can get the help I need.” I spoke with some residents the other day in New Mexico who said, “As I was reading this, all these experiences were extremely relatable, and I thought, ‘Yeah, I’ve been through that,’ or ‘I’ve been treated that way,’ or whatever it is.” And even really just knowing that someone else has gone through that has really been a big thing. So it’s been a very positive reaction so far.
Kevin Pho: And my final question: What is your take-home message for the KevinMD audience?
Kyle Bradford Jones: The take-home message is, don’t be afraid to get help if you need it, and be kind to yourself and recognize that it’s OK to struggle and to make mistakes, as long as we’re doing the best we can to improve and be our best selves.
Kevin Pho: And how can people find your book?
Kyle Bradford Jones: So it’s available on Amazon.com, Barnes & Noble. You can also go to my website, kylebradfordjones.com, and there are links there to buy it from your local independent bookstore. And so it’s available all over.
Kevin Pho: Kyle, thank you so much for sharing your story, and thank you for being on the show.
Kyle Bradford Jones: My pleasure. Thank you.
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