I come from a huge family and am the oldest of >30 grandchildren (and that’s only on my mom’s side of the family). My grandfather was the biggest influence in my life — he raised 11 successful children in the Philippines on his small salary as a school principal. My parents are 1st generation since my dad joined the U.S. Air Force, but we were fortunate to not have to move around so much, so I grew up in both northern and southern California.
2. How did you get into Psychiatry? What advice would you give to any medical students aspiring to have a career in psychiatry?
My interest in Psychiatry became apparent during my 3rd year of medical school during my hospital rotations. No matter which specialty department I was assigned to (Internal Medicine, Surgery, Ob/Gyn, etc), I spent a lot of time with my patients asking about their background and psychosocial aspects of their history, rather than solely focusing on their medical complaint. Anytime a patient had a mental health history or was on psychotropic medications, I requested that those patients be placed under my care. I became attuned to how mental health impacted a patient’s medical issues.
One aspect that fascinates me the most about Psychiatry is that there is an art to it — putting pieces together of a person’s life to formulate their current issues, in addition to awareness of how aspects of yourself can get triggered during the interactions. So much self-awareness and insight is involved, and I am constantly learning something new about myself in the process.
My advice to medical students interested in pursuing a career in Psychiatry would be to seek out rotations with Attending physicians who inspire you, find mentors (psychiatrists, psychiatry residents, other mental health clinicians, etc) who would be open to providing guidance and answering questions about the field when needed.
3. What or who inspired you to start blogging? What was the inspiration for the name?
I started reading fashion blogs in 2010 and thought it might be cool to write a blog that gave a glimpse of the life of a new doctor. I always enjoyed writing, but put the hobby aside because I was too busy with medical school and residency, but figured blogging could be a way to bridge my two interests in writing and psychiatry. My blog’s name, Freud and Fashion, was inspired by my fascination with fashion at the time and Freud being an iconic figure in Psychiatry, so I felt the combination of the two encompassed my interests while also sounding catchy and memorable.
4. What general advice would you give to people in stressful careers on how they can look after their own mental health?
Prioritizing one’s own mental health can be very difficult because being in stressful careers often means little time for yourself. I think an important factor is giving yourself permission to take care of yourself because people often feel guilty or selfish for making self-care a priority. Another step involves maintaining boundaries with your workload. For example, I have found that if I stay in clinic past a certain time, my mood changes and I’m irritable for the remainder of the day. Therefore, I stop working once the clock hits a specific time (though I’ll admit to breaking this boundary several times). Another component involves utilizing your support system (at work and at home). It’s often hard for people to give up control of certain responsibilities, but if support is available, then you might as well use it!
5. In your opinion, How do we eradicate the stigmas associated with mental health conditions?
I believe that eliminating stigma requires empathy, self-awareness, and normalization of mental health discussions. Many still believe that mental illnesses are signs of weaknesses rather than the fact that they are true neurologic diseases. Educating and raising awareness are important factors for understanding issues in mental health, but education can only go so far without empathy. To be completely honest, even I had my own stigma going into the psychiatric profession and it wasn’t until I acknowledged my own mental health issues that I was able to be more open, relate even more to my patients, and eliminate stigma from my mind. The more people are willing to talk about their own mental health, the more people can connect with one another to normalize discussions of mental health-related issues
6. Should mental health treatment be a greater social concern?
The following is a simplified response for a complex social issue, but yes, mental health treatment should be a greater social concern. The statistics of the prevalence of people with mental illness, the number disabled from mental illness, the number of people who do not receive treatment for mental health issues, the number of suicides, etc, are alarmingly high. And mental health strongly correlates with physical health (and vice versa) and delays recovery from major medical issues. Mental health services are limited and more resources are needed to provide adequate treatment. Generally speaking, I believe that mental health clinicians are overwhelmed and overworked due to the shortages of psychiatrists and resources (and they understandably have to look out for their own mental health as well) leading to burnout in effort to meet the growing needs trying to work with the limited resources they have. It’s a viscous cycle that needs to be broken through prioritization of mental health services and treatment via allocation of funds, recruitment of clinicians, and the list goes on.
7. What advice would you give to people within the medical profession who are suffering from a mental health condition and withholding that information from their employers for fear of being stigmatised?
I have advised medical professionals to weigh the risks and benefits of being open about their mental health conditions. Although a part of me wishes I could advise them to be forthcoming (especially since withholding this type of information often suppresses the individual and gives more power to stigma), I am also realistic. The decision often depends on the culture of the workplace — some are more accepting than others. And if one is confident and resilient enough to handle any potential outcome that results from providing the information, then I support self-disclosure.
8. Do you ever find it difficult to balance your personal identity as well as a professional identity?
I’m still trying to figure out my identity! It’s an ongoing process for me. I used to cringe when coworkers and people outside of clinic called me “Doctor.” I felt that the title created an automatic power differential and a barrier towards people getting to know me as a person, which made me uncomfortable. Since I’ve accepted that being a physician is a part of my identity, it doesn’t bother me so much now. Since my medical education pretty much dominated my life until I graduated a few years ago. I’m still trying to establish my identity as a whole. My ultimate goal is to be “me” whether inside or outside of the clinic.
9. In the past we interviewed Dr Pamela Wible, a spokesperson on physician suicide in the US. Recent studies have shown that medical students and residents are a prone group to depression. How can medical students or residents who follow this blog take measures to promote healthy habits and maintain their mental health?
By being open about my own struggles and ways that I cope, I believe I’ve created a forum for others to be more open about their own mental health issues. I have several medical student and resident followers and it’s amazing how social media creates a sense of connectedness and validation of the emotional issues that come up during the medical school and residency process. Life as a medical student and resident is extremely busy, so it takes a massive conscious effort to maintain mental health. I recommend finding a support system among classmates, co-residents, close friends/family, social media, meetup groups, a therapist/counselor, etc, to be a part of a team that motivates and supports one another. Having a sense of accountability to maintain healthy habits and selfcare is necessary because it’s hard to go to the gym, cook a healthy meal, or do something fun when there’s major upcoming exams or call shifts dominating one’s schedule.
10. What can we expect from your blog in the future?
I hope that my blog will continue to grow and provide opportunities to collaborate with like-minded individuals and organizations. I am amazed and humbled by having an international following, which shows how much providing a voice for those struggling with mental health issues and presenting a refreshing take on psychiatry is much needed worldwide.