The issue of who to trust when it comes to looking after your mental health is an ongoing one. Every week I hear from guys who are having a crap time on meds, and either are stuck with a doctor who won’t listen to their concerns or they feel unable to speak up for themselves.
Doctors and psychiatrists are authority figures. They’re the ones who are supposed to know things – after all, they have the years of training to prove it. So we should just shut up and listen, right?
This is a logical fallacy known as the “appeal to authority”. Just because someone is in a position of authority doesn’t mean we have to blindly accept everything they say.
As Stuart Sorensen points out in this excellent blog post, this doesn’t mean that experts are worthless. It means that we have to be critical in our thinking and judgment when it comes to making choices about who to listen to – not an easy task. Stuart provides a handy list of questions to make this process easier.
Let’s look at them:
- Is this expert skilled in this particular area?
In the case of a GP, how much does he or she know about mental health? In the case of a psychiatrist, you might expect this to be a given, but not necessarily so…
- What do the majority of similarly trained experts think?
Don’t be afraid to get a second opinion. Mental illnesses do not fit into discrete categories like diabetes or HIV. They are not tangibly visible via testing, so we need to look to consensus expert opinion to guide how we should be treated.
- What does the evidence say?
Research the medication you’re on. Admittedly, this can be somewhat offputting because of the myriad of side effects listed for each one – this is a legal requirement, and you’ll find it for any meds, not just antidepressants or antipsychotics. See what it’s typically prescribed for. Wikipedia is actually a good consumer resource for this, as it gathers together a lot of research, all of which is linked to and you can investigate separately yourself.
- How often has this person been right/wrong in the past?
- If they’ve been wrong before have they been prepared to admit it?
- Is this person ideologically driven?
- Is this person financially driven to say this stuff?
- Are there any other forms of bias you are aware of?
- Does the expert use real data as evidence or just rely on stories and anecdote (you can make any point you like in a story)?
This cluster of questions comes down to researching your practitioner. In the same way that you wouldn’t trust your car to Dodgy Bob’s down the road without first finding out his track record, don’t trust your brain and your body to a medical professional without finding out more about them.
You may find this in itself to be difficult, as some professionals play their cards close to their chest and don’t like people knowing about them as it makes them vulnerable to having their authority questioned. This in itself is a red flag.
For gay men, a doctor who is ideologically driven may be someone with a religious belief who is going to treat you differently because of your sexuality. This is important for you to know, because…
- If you follow them and they are wrong – will there be a cost?
- If you don’t follow them and they are right – will there be a cost?
Your life is potentially at stake. Bipolar disorder in particular has a shocking mortality rate. You need to make sure you have the right support and treatment around you, and that you can trust your network implicitly.
- What research could you do to check out their assumptions?
It doesn’t hurt to start with online research. Many GPs and psychs are now publishing blogs (like the good ol’ Healthy Bear) or at least have websites and bios online. Ask for recommendations from friends – it was word-of-mouth that brought me to my last GP in New Zealand, and the level of care was the best I have ever had for both my mental and physical health.
Don’t be overwhelmed by it all. There are plenty of good health professionals out there who will be suited to your needs. Just don’t be fooled by the “appeal to authority” and remember that you are the customer.