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Me and My Shadow: Understanding Mental Health Together

Guests of The Psychedelic Blog do not endorse, support, or otherwise advocate on behalf of any particular treatment approach for mental illnesses unless stated otherwise. The views expressed during this interview do not necessarily reflect the opinions or endorsement of The Psychedelic Blog. Readers should always consult with qualified healthcare professionals and conduct their own research before considering any treatment options. The blog and its authors are not responsible for any decisions made based on the information provided.


Shadow
What is in the Shadows?

The date May 4, 2006 is indelibly marked in my memory following a daytime meeting with a friend, whom I'll refer to as Candace for the sake of maintaining her anonymity. The pseudonym allows me to share her story while protecting her identity.


Candace's invitation to lunch at Rocky's Italian restaurant took me by surprise. We had been friends since 1993 yet Tuesday's lunch would be the first time we had ever seen each other during the day. Las Vegas is a 24-hour town and, if you're part of the day shift, as I was, the nocturnal lifestyle can seem quite alien to you. Bars and casinos that never close exist for tourists but there is an entire population of service industry workers like bartenders and entertainers who also make the night their own. I simply assumed that Candace, a dynamic singer and on-stage personality, was someone who worked late then partied with friends through the night. This lunch date, however, revealed that there was something much different going on in her life.


I'm not sure what inspired Candace's trust in me, but she decided to share secrets that were previously reserved only for her therapist(s). After years in therapy, she sought a friend's ear and, though I never asked, I thought that she may have chosen me because of my interest in human trafficking and the effects of trauma.


Candace shared that her childhood was scarred by her mother's physical and mental abuse. While she had always appeared supremely confident on stage, she revealed to me that this was just part of a carefully crafted facade to conceal the turmoil within—it concealed her anxiety and depression. This was a survival skill, a legacy of her mother's own struggles with mental illness; the product of a promise she made to herself never to be like her. Her mother had planted a crippling fear in Candace, convincing her that the shadow she cast housed her madness, using this fear to keep her close, keeping her from leaving the house. Her mother's death, when Candace was just 20, did little to ease these persistent fears or to better understand and interpret her mother's mental illness.


Of course, my perception of Candace had been based on that mask of self confidence. In fact, she didn't immerse herself in Las Vegas' nightlife as I believed. Instead, each night she would return home immediately after performances, spending her nights watching TV and obsessively planning her sleep to avoid the shadows of the following day where, her mother insisted, "the crazy you" lived. Therapy was helping and talking to someone, in this case me, was the next step in her recovery.


However tentative Candace's emergence was into the sunlight that day in 2006, we began meeting more regularly for lunches. I'm very happy to say that therapy really seemed to be working for her and, in 2010, Candace moved to the state of Washington taking a job in technology and eventually getting married.


I thought of Candace recently after reading an article in Colombia's El Espectador newspaper called, The most important thing in mental health is education. It made wonder, if there had been better ways of educating people and their families about mental health, could Candace have been spared years of anguish and pain? The person being interviewed for this article was respected Bogotá Psychiatrist, Dr. Guillermo Mendoza Vélez. He is Director of the Mental and Emotional Health Therapeutic Center. I decided to reach out to him in hopes of sharing his knowledge with The Psychedelic Blog and he responded immediately.


In this blog article, I have supplemented Dr. Guillermo's comments with those of another friend, Marcela. (Marcela is also a pseudonym to protect the privacy of my friend.) She lives in Medellín and is someone with first hand experience of Colombia's mental health system. Let's meet Dr. Guillermo then Marcela.


Man
Dr. Guillermo Mendoza Vélez, Director of Mental and Emotional Health.

"An excellent professional, he has been a great help in my recovery from depression. He takes the time to listen attentively and works on all of that."

-Andres, patient of Dr. Guillermo


Robert: Dr. Guillermo, please tell me about the Mental and Emotional Health Therapeutic Center.


Dr. Guillermo: Mental and Emotional Health (SME) is a health service provider (IPS), established in 2015, authorized by the District Health Secretary, where we offer outpatient services in psychiatry and psychology, with more than 38 different types of services (detailed on our website), leaders in online mental health care for Spanish speakers around the world, with patients in more than 25 countries. We provide adult clinical psychiatry and psychology services, child and adolescent psychiatry and psychology, specialized consultations in autism and eating disorders, family and couple therapy, cognitive-behavioral therapy, educational psychology, NLP for mental health. Our mission is to help people suffering from mental health symptoms, helping them to have peace of mind, well-being, and to recover their normal life and quality of life; we also help educate people on mental health topics, either in psychotherapy (helping them to improve their self-perception, achieve better outcomes, and resolve their conflicts) or through external mediums like social media, live events with partner accounts, media (radio, newspapers, television), and talks to companies and universities.


Robert: How does your Center interact with the public?


Dr. Guillermo: We interact in many ways:


  • Through the website: It can be accessed from Google search, Google ads, social media, and media. On the page, we show the characteristics of SME, the 38 services, the team of professionals, and we have a blog with more than 40 articles on mental health.

  • Social media: We have Instagram and TikTok accounts, where we share relevant information on mental health topics of public interest in a simple way, through various means, reels, long videos, and series of images.

  • Through WhatsApp: When people are interested in acquiring one of our services, they can write to us during office hours at our numbers 2101616 and 3185274032 for face-to-face consultations in Bogotá or online anywhere in the world.


Robert: How did you start your career in mental health?


Dr. Guillermo: I studied medicine at the National University of Colombia, graduating in 2000. Later, I specialized in family medicine, and shortly after in Psychiatry at the Clínica Montserrat - Universidad El Bosque. From the beginning, I conducted private consultations independently, but I also worked in various contexts in outpatient mental health clinics, psychiatric services in general clinics, and care in EPS (Health Promoting Entities) and prepaid medicine. In March 2015, I started with the personal brand Mental and Emotional Health, soon enabling it as an IPS, and increasingly adding more professionals to our team.


Robert: Why do you think education in mental health is so important?


Dr. Guillermo: Psychiatry and psychology have been stigmatized since their inception, and this greatly limits people's access to care. Patients suffer from anxiety, depression, and other symptoms, the suicide rate is increasing, there are more and more disabilities due to mental health issues, and these pathologies are currently the second leading cause of illness in the world. Therefore, it is important to fight against stigmas*, to show the population that we are health professionals like any other, that it is important to work on mental health, to learn about the main mental health problems from experts and not from uninformed opinions, that these problems have treatment, and thus be able to help more people manage their symptoms, and improve their quality of life as well as their personal, family, and academic/professional performance. Most of the time, people minimize their symptoms and do not seek mental health services due to a lack of information and misinformation about the subject.


Stigma

 Definition: Stigma refers to negative attitudes, beliefs, and stereotypes associated with mental illness. It often leads to social exclusion, discrimination, and barriers to seeking help or support.

• Explanation: Stigma surrounding mental illness can prevent individuals from seeking treatment, disclosing their condition, or receiving understanding and support from others. It can perpetuate shame, silence, and a lack of empathy.

• Example: Stigma can manifest in various ways, such as labeling individuals with mental illness as "crazy" or "weak," or treating them differently due to their condition. Addressing stigma is crucial for creating a supportive and inclusive environment for those affected by mental health challenges.

• Quote: "Stigma is a barrier that keeps people from reaching out and getting the help they need." - Bell Let's Talk campaign


Robert: Readers of The Psychedelic Blog will note that the issue of stigmas is a recurring one. We'll explore this more throughout the blog. Dr. Guillermo, how do you propose that mental health education be disseminated in Colombia?


Dr. Guillermo: Through media. Significant advances have been made in this millennium, we see more and more specials on mental health, and people are becoming more aware. I would propose emphasizing that mental health issues are just that, health issues, not weaknesses, fabrications, character flaws, or attention-seeking behaviors. Also, to normalize visiting psychologists and psychiatrists as a necessity and not as a luxury or something for "crazy" people. I would propose that insurers (EPS, prepaid health services, insurance policies) give importance to this issue; we are very lacking in this area. As providers, we see the absolute lack of interest from insurers in providing better mental health services, there is no emphasis on this, no educational campaigns for their members, and even less so specialized programs. Even when trying to enter through these means, mental health providers and educators find absolutely closed doors. In schools and universities, either in classes or through their dissemination mediums, share accurate information about mental health. In companies, to give importance to mental health talks for their workers. Often, we see that there is no interest, or if there is, it's very basic, almost to get it over with, or as a requirement, or even something for workers to believe that interest is being given; but in reality, there is no investment in specialized programs to improve the mental health of employees, which would improve their performance in the short and long term, and consequently, that of the company. And of course, through social media and blogs, encourage professionals to provide a lot of quality information on mental health, educating the community through these free mediums.


Robert: If you could fulfill a dream about mental health education and had unlimited financial resources, what would it be like?


Dr. Guillermo: Apart from emphasizing and being more present in the promotion of educational campaigns in the previously mentioned points, I would write a book about the topic, that impacts people and shows them mental health in a closer and friendlier way, not as something macabre or distant from their day-to-day life.


"I've been with Dr. Mendoza for about a year, and I must say he is a very

good professional and human being."

-Angie, patient of Dr. Guillermo


Robert: At what age should mental health instruction begin?


Dr. Guillermo: Of course, children and adolescents should know that these problems exist, just as orthopedic problems, diseases like cancer and heart issues, infections, etc. do. Clearly, there are different ways of educating depending on age, but generally, they should know that it exists and that mental health is something close, like any health issue, not something isolated for "crazy," "unstable," or "mentally weak" people.


Robert: Would you include bringing professionals for classroom visits, or could it be done through lessons taught by teachers?


Dr. Guillermo: Although I'm not an expert in mental health in schools and have never been in these environments, it could be done during health days if schools take this initiative. Also, I have seen that many schools discuss scientific topics during special weeks, and the topic of mental health has been present in the exhibitions of the students themselves. I don't believe it is the job of professionals to delve deep into the subject, but at least to mention it and give it importance, in the corresponding subjects.


Robert: How can technology be used to assist in this initiative?


Dr. Guillermo: Currently, we have numerous technological tools for this, the most used, of course, is social media and online information channels. Also, there are numerous applications that help people improve their mental health.


"An excellent professional, I was in very bad shape when I arrived at my first appointment,

but from the moment I arrived, he conveyed a lot of calmness and assurance which was fundamental for my recovery. Thank you very much, Doctor, for being

an instrument of God to help me!"

-Victor, patient of Dr. Guillermo


Robert: How can young people help each other with mental health-related challenges?


Dr. Guillermo: Firstly, by not being afraid of the topic, but knowing that it is common to suffer symptoms in their mental health, and that it is a topic free to express. The sense of camaraderie, respect, acceptance, and opposition to bullying are very effective ways to prevent future mental health problems. Friendship and closeness are ways to support peers who suffer from mental health issues, but always keeping in mind that they are not professionals or therapists, they should encourage consulting, or that a responsible adult takes charge, so that the young person accesses mental health services.


Robert: What book or movie had a significant impact on you when you were a child?


Dr. Guillermo: I don't remember in childhood, but I can talk about middle and late adolescence. There is a special book I read at 15 years old, The Greatest Secret in the World by Og Mandino, given to me by a private teacher, and it greatly impacted the way I saw people's potential. Its scrolls have marked my philosophy of life for 30 years, it's a book I re-read a lot since then, and many of its principles I teach in consultation. Additionally, it opened the doors to my strong interest in personal development and growth. And, a movie, at 17 years old was Patch Adams. Although it doesn't accurately describe the biography of this figure, the movie opened my eyes to a different type of medicine, to warmth, empathy, and the true interest in people, beyond individual needs.


Robert: Who is a historical figure you admire or find particularly inspiring?


Dr. Guillermo: Independent of the religious theme, and without having much to do with it, the person I have always admired for almost 30 years is also Jesus. I have studied a lot about his life, his work, and his messages, learning about themes of love for one's neighbor, sense of life, leadership, thinking big, empathy, self-confidence, among hundreds of other things. Whenever I want to learn something or develop something in me that makes me grow, I refer to the Gospels to learn from that factor studying the life of Jesus. For me, he has been the character who has most influenced the history of humanity. I say this, independent of religious beliefs.


Sagan
Dr. Carl Sagan, a prominent voice for science education

Robert: Do you have any memories of Carl Sagan or his public education about the cosmos?


Dr. Guillermo: I had always heard of Carl Sagan, but I really started to become interested in him and his message in 2022, when I read his book The Demon-Haunted World, which greatly influenced my way of thinking and opened my eyes. That year, I read some books by Stephen Hawking, and also watched some episodes of Sagan's Cosmos series on the Internet. But more than his message, it's his method. He inspired me greatly to follow the plan I pursued. He was a popularizer of science, educating the community in a very simple way on a topic as complex as astronomy. Although I don't have a special interest in astronomy, since I started to see Sagan's work, it has been a great inspiration for me to do the same in mental health. I am a clinician, I see people, I am not a researcher or a teacher, I don't work in laboratories or research centers, but I can be a disseminator of these mental health topics, topics so complex, and like Sagan, disseminate them in a simple way, and I have him as inspiration for this purpose.


Robert: Awesome, Dr. Guillermo! This has been excellent.


To dig a little deeper, I asked a friend to describe her experiences with mental health services in Colombia.


Robert: Marcela, how did you first encounter the mental health system?


Marcela: The first time, I was referred by a general physician with a presumptive diagnosis. He then directed me to a psychiatry and psychology evaluation. Being there in the mental hospital, what I noticed is that there are many flaws in attention regarding appointments; it takes a long time to give control appointments to patients. In my case, they gave me a medical prescription for 6 months so that in that period I could find an appointment, because they are always overwhelmed.


Another factor is, due to the health contingency, I have never had an appointment with the same doctor; it varies a lot from doctor to doctor and because of that, I have gone through different diagnoses. Each doctor in their expertise has different criterion. Another factor is the pharmaceutical part. The medication often runs out because it does not provide continuity or good adherence to pharmaceutical treatment. And the psychology therapies such as dialectical behavioral therapy or cognitive-behavioral therapy are so expensive that the health system in my case does not cover due to their high cost. These would be the barriers that I, as a psychiatric patient, have encountered with respect to the mental health system in Colombia.


Robert: Before or after your diagnosis, were you ever affected by the stigmas of mental disorders?


Marcela: Before the diagnosis, no, because people in my environment perceived me as a weird or different person or "crazy", since they found some of my behaviors strange. After the diagnosis, I have felt more stigmatization. At an academic level, people have made comments to me that have been discriminatory and ableist, thinking that people with mental conditions or neurology are all headed in the same direction, that is, if you are autistic this career fits more to your condition, you would be good at this or that.


Robert: How well do you think the government and/or health professionals communicate to the public the challenges related to mental illnesses?


Marcela: Well, I consider that we are in a period of a lot of information but at the same time, there is also misinformation. Now, with social networks, people tend to obey or inform themselves more through them than through scientific articles that are valid. But I can say that now there is more talk about mental health and there is an attempt to raise awareness among the population about these issues. In Medellín, psychology listening posts have been implemented in primary level hospitals, in the metro, so I consider that professionals want to make these problems more visible and provide help.


Robert: If you could change or improve one aspect of mental health care in Colombia, what would it be?


Marcela: Accessibility to service. People living in rural areas of the country have to travel to cities to be able to have appointments with specialists such as psychiatrists, and medical appointments in these specialties tend to be delayed. I consider this a gap in the mental health system in Colombia.


Robert: Thanks so much for speaking to us, Marcela. If there's one thing that almost all countries of the world have in common, it's their struggle to bring mental health issues into the light. To wrap up our discussion, I've asked and answered a couple more questions about stigma.


Why do stigmas hold back progress in understanding mental health issues?


Reluctance to Seek Help: Many people hesitate to seek treatment for mental health issues due to fear of judgment or discrimination. Stigma leads to a situation where mental health conditions are not treated with the same urgency or seriousness as physical health problems.


Lack of Awareness and Education: Stigmas perpetuate a cycle of misinformation and misunderstanding. This can hinder public health initiatives aimed at educating the public about the nature of mental health conditions, how common they are, and the importance of seeking treatment.


Funding and Resource Allocation: Stigma can influence how resources are allocated for mental health research, treatment, and prevention programs. Mental health services may be underfunded compared to other areas of healthcare, limiting advancements in treatments and access to care.


Social Isolation: Individuals experiencing mental health issues may isolate themselves due to stigma, worsening symptoms, and hindering recovery. Social support is crucial for recovery, and stigma undermines this support system.


Workplace Discrimination: Stigma can lead to discrimination in the workplace, where individuals may be overlooked for employment or advancement opportunities due to their mental health conditions.


What can we do about stigma?


Education and Awareness: Promoting education and awareness about mental health can demystify mental illnesses, correct misconceptions, and change negative attitudes. This involves integrating mental health education into school curriculums, workplace training programs, and public health campaigns. This is the work Dr. Guillermo is talking about.


Encourage Open Conversations: Creating safe spaces for people to share their experiences with mental health can foster understanding and empathy. Encouraging public figures and influencers to share their stories can also help normalize these conversations.


Improve Access to Care: Like Marcela had mentioned, ensuring that mental health services are accessible, affordable, and culturally sensitive can help more people to seek the help they need without fear of stigma.


Support Policy Change: Advocating for policies that protect the rights of individuals with mental health conditions and ensure they have access to quality care is crucial. This includes workplace policies that support mental health, insurance coverage for mental health services, and funding for mental health research.


Challenge Stigma When You See It: This involves calling out stigmatizing language and behavior in social, professional, and media contexts. Educating others about why certain words or attitudes are harmful can contribute to a broader cultural shift.


Thanks again to my guests Dr. Guillermo Mendoza Vélez in Bogotá and my friend, Marcela in Medellín, Colombia. We all have some work to do.


Check out Dr. Guillermo's Instagram at: https://www.instagram.com/saludmentalyemocionalct/


If you enjoyed this blog, please consider sharing it with a friend. Interested in writing a blog article like this? Contact Robert@thepsychedelicblog.com. 




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