Not thinking before you speak

Greetings all,

I begin this post by declaring that I know that in Australia we are fortunate to have the right to free speech. In particular, I am referring to Mr Mark Latham’s article published in The Financial Review last week which has caused an outrage amongst women who have mental illness or care about those who do. But what I struggle with is when those who speak from a position of influence don’t think before they speak. Or if they do and they are found to be incorrect, or indeed cause harm, don’t apologise.

I have no legal training and I am not a journalist, and don’t claim to know about tactics to sell papers or how a person is chosen to contribute to content. I am however a psychiatrist who can spend up to half her time in initial sessions with some patients reassuring them about what I can offer them and why it is a sensible and medically advised decision to seek help for mental illness. It is why I wrote my book “How Shrinks Think”. It’s where I see the most stigma. Behind closed doors, people suffering that I know we can help, but those that would be horrified if their friends or colleagues knew they were seeing a psychiatrist. Those I see get better, sometimes with medication, and still don’t want anybody to know they have a mental illness.

I can’t comprehend why Mr Latham would comment about mothers and mental illness, especially during BeyondBlue's post natal depression awareness week (16-22 November 2014). I do consider it necessary to set the record straight regarding depression and motherhood from a psychiatrist’s point of view.

If a woman is biologically predisposed to developing a mental illness they are more likely to have an episode at the time of hormonal fluctuations, i.e. during puberty, at the time of menopause, and guess what, while pregnant and after childbirth. Hence why the subspecialty of perinatal psychiatry exists. Hence the scrutiny for the emergence of post natal depression in biologically vulnerable people to protect the mother and in extreme cases the baby. See the logic there Mr Latham? The baby doesn’t force the mother onto antidepressants, the mother isn’t weak but the mother may be biologically predisposed to the development of depression, with episodes triggered by these hormonal fluctuations. Fantastic, capable, loving mothers who also have a personal or family history of depression. Thank goodness we do have effective treatments, dedicated mother‑ baby inpatient and outpatient services that care for both mother and baby while keeping them together to encourage bonding. 

Guess what else, Mr Latham, we know that we need to help the mother for the infant’s well-being as well. Something the child will not be blamed for, but the child may thank the mother for.

I have heard the notion that antidepressants are a band aid, a happy pill, something to become reliant upon or change people’s personality so many times it’s really not funny. No endocrinologist would cop the same when prescribing insulin to a 4 year old child who has type 1 diabetes. If a mother has depression she should not be made to feel ashamed if she needs to take antidepressants.

So I do concede Mr Latham has a right to freedom of speech but I would prefer it be informed and evidence based. I ask the Financial Review to accept utmost responsibility for publishing these remarks, pointed towards a successful and happy mother, by retracting the article. Remarks similar to those Mr Latham has made in the past regarding patients with mental illness. Then I can carry on working to debunk myths, educate and above all help my patients as my profession would want me to do.