Anthony: Hello And welcome to Capes on the Couch. where comics get counseling. I’m Anthony Sytko
Doc Issues: and I’m Dr. Issues.
Anthony: This is a special episode. This is a guest. Not really sure what to call this one. It’s not exactly creators on the couch, but this isn’t a standard comic book character issue either.
But it’s a conversation we wanted to have and it’s a guest that we’re certainly thrilled to have. We are happy to welcome with us, the founder of We Matter Too and a very prolific mental health advocate in our own right. Dr. Ashley Perkins. Dr. Perkins, thank you so much for taking the time to join us this evening.
Dr. Perkins: Absolutely. Thank you for having me.
Anthony: So Dr. Perkins, you are, as I said, the founder or the co-founder I believe of we Matter to. And the motto is together end the stigma, and that is something that Doc and I have spoken about at length many, many times for the past four and a half years on this show is about ending the stigma around the conversations around mental health.
So when I saw you very active on Twitter and I said, this is someone that we absolutely need to get on the show to get that kind of insight. So again, we’re very happy to have you here. So before we get into, we Matter, two, tell us a little bit about your background and how you came to, represent this field.
Dr. Perkins: So, I graduated from Butler University in oh eight with my doctorate of pharmacy and started out as a community pharmacy. So worked for CVS and some independent pharmacies. And so my husband works for the railroad, so every time he got promoted, we got moved. I’ve collected three state licenses along the way.
We’ve lived in Maryland, West Virginia. Where else have we lived? Kentucky. We’re now in Florida, so we’ve, we’ve moved all over creation. And finally I decided I needed to get out of community pharmacy because, well, community pharmacy burns you out. And so I decided to start teaching students.
I joined Marshall University in 2017 in West Virginia. And I started teaching pharmacy students, and that’s when I started to get into mental health. Like I started to get into that area because I started teaching in that area. And unfortunately at that time I was, I volunteered for a youth organization for almost 20 years at this point.
And unfortunately I had a board member discriminate against me for my mental health. And of course I reported it. I did. I mean, I’d never had hidden my mental health from anybody. And they didn’t do anything about it. I went through the whole retribution. I ended up having to resign my position.
I held a high position. I was the leadership seminar chair for one of the state sites at the time. I ended up resigning my position. Went through eight months of bullying and emotional abuse before I finally decided to leave the organization. Again, after 20 years of being part of the organization.
That lasted for about eight months in 2019. So after that happened and I left, I told them, This wouldn’t be the last time they heard from me, because I was going to raise awareness about what happened because this wasn’t okay. Really, what they wanted me to do was to sit down, be quiet, and not talk about it anymore.
They wanted to silence me and get rid of me, but. That’s, that’s not how I roll. Like, I, I don’t sit down and shut up very well especially when something bad has happened and I know it’s wrong. So I left because there was nothing else I could do. But I knew I wanted to do something, something. And here I am, a pharmacist, educated I have privileges as a pharmacist.
And I’m working within this space as, as a pharmacist. And I’m like, there’s got to be something I could do. And this was towards the end of 2019, going into 2020. And I was talking to my friend John, who I also knew from the same organization. And I had this idea, What if we start this organization where if we all have these lived experiences with mental health, we’re already breaking that barrier down.
More people are gonna feel comfortable talking with us. The problem getting people help is that they don’t feel comfortable talking to the people that they’re approaching. So if we already have told people, Hey, we have these problems too. We can get more people help and they feel comfortable talking to us.
So it’s like support. Anyway. Why don’t we just start an organization where we can do this together and we can raise awareness about the discrimination that happens because it just happened to me. And he’s like, You sound like you have an idea. Why don’t we just do this? So we matter to started and we started filling our paperwork out at the end of February, 2020.
Not expecting March of 2020 to happen . No. Did that to happen?
Anthony: I don’t think any of us saw March of 2020 happening the way that it did, right? Yeah, exactly. So,
Dr. Perkins: but we started to fill our paperwork out. And that’s when we started it, because I knew I needed to do something and John was literally there the entire time.
It all happened to me and I trusted him. And so we decided to do it together because why do it by myself when I can do it with someone else? So we co-founded it together and we did it, and we just started doing it. And I don’t think we realized it was going to take off as quickly as it did because when I joined Twitter in June of 2020, that’s when I started on Twitter.
I just got made an account. And since June of 2020, I’ve grown, I’m over 7,000 followers now. I’ve done a TED Talk, I’ve written a book. I, I do podcasts and speak and all of that type of stuff. I’ve won an award, but like, that’s the point is, is that we didn’t expect all of the things that we’ve been able to do in the amount of time that we’ve done it.
But I also think I underestimated how mad I was .
Anthony: It’s interesting that you say that because anger in that sense can be such a fantastic motivator. And we have a tendency, and we’ve spoken about this on our show numerous times, that we judge and label emotions when emotions are not the problem. It is the actions we take.
For those emotions that I feel can be and should be appropriately judged, positive, negative, et cetera, et cetera, at least to a greater extent than the emotions, the base emotions themselves. There’s nothing inherently wrong with being angry, sad, what have you. It is the actions that you take in furtherance of those emotions that create the problem.
Doc Issues: Yeah, and, and I mean, on one hand, I don’t think anybody, depending on their personality, some people do, but most people don’t really expect instant success or, or rapid success or things like that. But at the same time, when there is an obvious need for something, then society at large hears the call.
And I think that’s what’s happening here, because for too long people have felt silenced and, and. Professionals of, of all levels at this point are really feeling that. I think that especially these past few years, it’s definitely come to a head. To dovetail on that as a physician within our network, when Covid hit, especially, we have an employee assistance program and things like that, and we have mental health workers that are able to reach out.
If any of our providers, nurse practitioners, doctors all specialties, whoever, if they felt like they needed a hand reaching out and. My boss who also is a psychiatrist, he told me, there were nights I would wait for the phone call. He said it was interesting.
He would be in a doctor’s lounge and he would hear people crying and he would hear the yelling and screaming, the frustration, all of this, the things that are going on in people’s personal lives, all of that stuff. And he was the one that was the organizer and the supervisor for anybody calling in crickets.
He would not get a call. And he took the opportunity to pull someone aside and he said, Look, there is no reprimanding here. No, no negative consequences. All that, I just wanna know, because some of the things that this person would, was just venting to, He said, I’m here for you. And, and the person said, I understand that you as the individual are here for me, but the organization, the state licensing board, the professional association, are they there for me?
And can I trust that it’s nice for you in the moment. But they, they basically said, There is no way I’m going to trust these larger organizations to have my back. And he, he had to, he had to basically keep his mouth shut because he said he didn’t have an answer for that .
Dr. Perkins: And that’s so everything, and that’s what we try to explain to people is that we, we tell people we’re not therapists, we are not train.
Like we’ve all gone through mental health first aid and I’m in the process of getting my boards as a psych pharmacist. So like I, I have extra training. I’m not just a pharmacist, I’m a psych pharmacist. So like I have extra training. But like there is something to say for people with lived experience who can just share experiences with each other.
and form bonds with each other. We’re not treating, we’re just talking to each other and with such a backlog of getting into therapists and getting into counselors and social workers right now to get treatment. The way I see this, I see this as just that holding spot. We’re just helping people right now in this holding spot until we can get them to that next, and we’re just there for each other because that’s all that the Twitter, if anyone has come into, we just call it the community, and it’s just literally a space where people come and hang out on Twitter.
It’s very weird, but it’s like that’s what it is, and like people just come and talk and. Associate and share, and you can lead a past to come. It’s just come exist and it’s inclusive and it’s for people to just be, It’s a wonderful place to, it’s a very inclusive event. Actually, this past weekend has been a rough weekend for me.
I’ve dealt with a little bit of cyber bullying and the whole community has just hung and been like, Are you okay? Is everything all right? You, And they’ve been there for me. So like, it’s just a place where people feel comfortable. But like you said, there’s nobody there watching you . And you can be anonymous if you want.
Anthony: Yeah. A shared safe community space is so important these days, especially. I mean, now we’re in, the new era of Twitter and so far everything I’ve seen says strap ourselves in. It’s gonna be a wild ride. And so I feel like creating those types of environments where folks can come in and to your point, just be is so vitally important.
And it’s important to note, Doc and I both cis hetero dudes, that we have such privilege and we understand that, we’re aware of that. But not everyone has that ability to walk into a room and not have to worry if someone there. Wants to, to hurt you or worse just for existing.
And so we are very proud of the community that we’ve built. Small, though it may be, we’ve got a Discord, we have conversations, we’ve, we’ve been contacted through dms in emails, et cetera, from people and, and we have a channel in our Discord server that is literally just for mental health and being able to say, Hey, I’m struggling with stuff.
I’m going through a rough period. Our friends over at Guardian’s mh, I dunno if you’ve ever had an opportunity to speak with them. They have a, a 5 0 1 C three as well. And they’re very much on that same vein of, of creating that kind of safe environment. And they created something called an RTS bot Real realtime support, I believe it’s called is what it stands for.
And it gives you an opportunity to have access to services that if you are, if you’re in crisis, It provides you with a list of resources. And it sounds very much like that’s, that’s what we matter too, is it’s giving people an opportunity and access to resources that they may not necessarily be aware of off the bat.
Right. And, and that is so, as I said, vitally important in, in this day and age, and especially even just in America where, I’m not gonna get on a soapbox about the state of mental health. We’ve, we’ve done episodes about that, but Doc, I know you, you’re looking like you’ve got something to say as well.
Doc Issues: Well, because even just day to day, not just in social media, but I, I work at a hospital and one of the most rewarding things that I get to see during the week is one of the local organizations, their name is Journey to Wellness. And, and they’re fully. Peer support, not considered professional trained or anything, but they, they’ll have groups on our unit just to let people know.
Like, it, it’s okay. This is not something where you always need a professional with a license just holding your hand, doing everything a certain way or focused heavily on medication or things like that, which of course is my bias cuz it’s what I do for a living. It gives the people an opportunity to learn about, just random gatherings get togethers in the local community.
And they point out like, this isn’t a pressure thing. It’s not like, Oh, well you have to make a certain number of meetings to do this or that. Like, nothing like that. It’s just very inclusive and, and open minded. And to see people in real time, I know that that can have a greater impact in terms of a person’s quality of life than whether or not I’m making sure they are taking a medication every day.
And sometimes it works both ways where patients have said to me, You know, I really wasn’t gonna follow up with anything, but I talked to, insert person here. And, and they actually said they went to the same program and, and it seemed pretty cool. I’m like, Okay, great. I’m glad they, they opened your mind so that you’re more receptive to that or whatever, you know?
So I get to see it in, in real time with people in person. And I know that social media has that capability. And I’m aware of the, the cyber bullying thing as well, only because I try and do my homework before any any podcast guests and seeing that what was disturbing to me about it, not to go into details.
And I’m not going to, to try and retrigger anything. It’s just that I, we just said this before starting the recording, or at least I did. Sometimes it’s professional and professional and I’m like, What, what are we doing? Why, why create this drama? I don’t understand the, that aspect of it. I think people can have discussions about things that maybe you’re not seeing the, seeing eye to eye in terms of different techniques or different philosophies on things, but that’s different than saying, I want to make this person feel bad.
And that’s what I think a lot of that is. And, there’s literally no point to it. I don’t understand it. I’ll admit, I can’t comprehend why anybody would do that to another human being. And the idea that I’m grateful, clearly we have enough people together that are able to combat that and squash it so that it doesn’t become too pervasive, which is always my fear.
And I admit this is, Like not a hidden thing at this point. Anybody that knows me, I have a lot of social anxiety, so the online social anxiety is probably bigger now than anything I ever experienced in person. . Mm-hmm. to, to see those things happen, I’m like, man, oh man, I am so grateful. There are so many people that demonstrate a level of cohesion and strength to, to put it in its place so that it doesn’t get outta hand.
Dr. Perkins: Yes, Yes. We have a community of people and, as an advocate I, I take it very seriously to make sure that we’re protecting as many people as possible. And unfortunately that meant me putting myself on the line to call for accountability and. I unfortunately made myself a target, and so it was rough and I’ll deal with it for probably a while.
And it’s the same thing with the discrimination thing. Like I could have ignored the person who did it to me and just let it go. But my thought process was if I let this go, person’s gonna do it again, and I let this person do it again to somebody else, and I can’t do that. Like my brain doesn’t let me do that.
my brain says I need to do something because I can’t let somebody else be harmed. Same thing goes with this is I feel like I have, I know there’s other people that have been harm. If I don’t do something, I’m letting other people be harmed. So I need to do something about it. And this was my way of standing up and saying, This isn’t okay.
Other people have been harmed. I know that I’ve also been harmed, so I need to stand up and say something now. Yes. Had it been a year, of course it had been a year. I was terrified to do something about it, but I did something, It wasn’t fun. But it happened. And I’m taking a mental health day from work on Monday cuz I just need to, But I already called my boss and I also mentioned to my boss, she might get some emails just so she knows.
I’m also supported at work, so it kind of comes with the territory when you’re working on, on social media. And this is actually the first time I’ve dealt with something like this, so I’m actually pretty lucky considering I’ve been on social media now for a little over two and a half years.
So I’m pretty fortunate. Our community’s really good. We have a wonderful community of people who are very supportive of each other, so I figure it was worth it. I don’t, I mean, it was worth it for the community of people that we have. So,
Anthony: yeah, it’s always difficult when you were the figurehead, so to speak, or spokesperson, whatever terminology you wanna call it, in the sense that on one hand you don’t want to give these types of things, oxygen.
So there was always that mindset of ignore the bullies. I was always told growing up, don’t pay them attention. Don’t, don’t pay them any mind and they’ll just give up and go away. Sometimes that works. Sometimes people are in it just for the lulls. They’re just in it for the reaction, and sometimes they’ll just, yes, give up and, and move on for better or worse to another target.
Other times it becomes emboldening that, oh, they didn’t say anything if I said this. Hmm, okay, what if I say this? And they take another step and another step, and this unfortunately goes well beyond social media. We see this a lot in the real world play out. We’ve seen this a lot over the past decade or so, that folks that are a lot more.
Comfortable with saying the quiet things out loud and turning what used to be coated language and dog whistles into foghorns and Claxons and just saying, oh, okay. This is fantastic. I mean, they just had the report now that over I forget the percentage, some drastic percentage increase of the use of the N-word on Twitter in the hours following Elon Musk buying it.
That’s the kind of thing we’re talking about is trying to put a stop to it, nip it in the bud before it gets out of hand. But again, it’s, it’s a balance because as I said mm-hmm , sometimes you don’t want to give it oxygen because then if folks see that they’re getting the response, Oh, you think that’s bad?
Okay, I’m just gonna try that. And that’s. That’s where the, the trolling comes in. Yeah, and, and side note, I’ve always had an issue with the overuse in the watering down to the term troll. Troll to me is somebody who says something very intentionally to elicit a particular response from somebody.
Oftentimes playing dumb like that to me is a troll. Somebody who says something obtuse to get you to respond and take them seriously as though what they’re saying as, as though they believe what they’re saying when they very clearly don’t. Nowadays people say, trolls is anything negative on social media?
And I’m like, No, no. I hate to be that, you know, kind of gatekeeper about the term troll. But ,
Dr. Perkins: a lot of terminology that happens on Twitter is like, once a word gets like in the terminology and that it gets overused very quickly. Like really quickly . And that happens so much. It’s like the more, the longer I’m on Twitter, it’s like Twitter is his own beast.
And it’s very weird. Like my husband doesn’t get it. He’s not on social media much. And I’ll start talking about stuff and he’s like, You’re talking about Twitter stuff, aren’t you? And I’m like, How’d you know
Anthony: Yeah. There’s that old expression that a lie can get halfway around the world before the truth has a chance to get its pants on. Now, with social media and fiber optics and high speed internet and everything, a lie has circulated the globe numerous times and has gone viral as a hashtag before the truth even goes, Wait, what?
And the sadder part is that even when the truth is out there, The lie continues to circulate. It’s not a situation of, oh, once the truth comes out, then people forget the lie or the, the truth overtakes the lie. It’s no, you still have people believing in the lie. Mm-hmm. , and that’s not, that’s not even a political thing that goes well beyond elections and things of that nature that is just, that’s just, you know, common or human nature and base understanding of, of psychology.
Doc Issues: I have a question related to all of this, because Yeah, clearly we are, we’re talking about Twitter, which as you said is its own beast. But you’ve also written a book, you’ve also given a TED talk, so I, I’ve seen it on, on YouTube. And I’m wondering, of all the different media types is there one that you consider to be preferential in terms of delivering messages or, or fostering that community?
Dr. Perkins: Well, we seem to do well on Twitter. We just, I think because of the shortness of the tweets a lot of our community does well with the shortness of the tweets. Now, I won’t lie, a lot of us struggle with the rapidness of movement because we do have people with h d with, with autism, with PTs d with traumatic brain injury.
So like a lot of the rapidness of Twitter, a lot of times we’ll confuse a lot of people in the community. So like a lot of times you’ll find people will DM each other and be like, I’m confused by this. Can you explain it to me please? And I am one of them , because usually if there’s a, conversation that’s going awry because people are rapid fire or tweeting, and I’m like, I’m like, What’s happening?
All I do is if somebody else I know is in it, I’m like, I just go to the DM and I’m like, Can you explain what’s happening? I’m confused , because with, with my ADHD and autism, like I will get so confused and, and then if there’s context that I am supposed to be teasing out that I get lost in anyway, someone’s gotta help me because I am lost and I don’t wanna, and I don’t wanna misinterpret something that I, especially if I’m talking to somebody and I don’t wanna mess it up anyway.
And I wanna make sure I understand. So like, I’m usually trying to understand people so like it can get hanky at times, but we’re also really good at giving each other grace. When somebody messes it up. So like if somebody misinterprets something that somebody has said, instead of jumping on them and getting mad at them because they misinterpreted you, you just say, Oh, no, no, no.
That’s not what I meant. I meant this. I’m sorry. You misinterpreted me. Like we’re pretty good about that. Or if someone does get upset, I’m sorry, I didn’t mean that. I apologize. Like mm-hmm. , we usually try to do the best we can. Now, of course it doesn’t always go well and sometimes we have upset people, but it happens because again, when you’re dealing with mental health issues and neuro divergence, you’re gonna have issues.
But as long as people, because see my rule on my threads, I have a pinned post for a reason. As long as we’re treating everybody with respect and we’re doing the best we can, then everybody’s fine. You know, it’s when we start doing the low blows and we start, you know, reaching for name calling and we start getting rude that I step in and I’m like, Okay, like there’s no need for this.
It was a misunderstanding. Let’s just try to be nicer and let’s try to go with the perspective of this was a misunderstanding. Nobody meant any harm. And then if I have to, I block ’em. That’s the rules. Everyone knows the rules.
They’ve been the rules for almost a year now. I, I give people a chance. If they can’t calm down or understand, then I block them.
Anthony: Well to that, to that point. I would say just as a caveat, that I think it makes the presumption that the people involved are coming from a place of seeking to understand.
Yeah. Because without that, then the whole thing kind of falls apart. It’s a trust system. Mm-hmm. , it’s an honor system. Absolutely. I am hoping that you are seeking wisdom, understanding, awareness, whatever that, whatever that may be, this, this higher knowledge. Same as me. If you are not, then we do not have any real thing in common.
And I was just having this conversation with my sister recently. So much of social media is built upon gamification, that understanding. is way down on the list of priorities that mm-hmm. , and we were talking about this before we actually started recording. There’s no room for nuance because it’s not profitable.
Nuance requires length, it requires understanding, and it requires a common level of, of courtesy and respect. Mm-hmm. present to all people within the community, under a social media network created to function within a capitalist system. Those two things are necessarily at odds.
Mm-hmm. , you cannot create, I shouldn’t say you cannot, but it has yet to be created where a social media network provides that kind of, Understanding in space, at least in that regard, writ large. Mm. Anyone, any, anyone who has used a social media company in a social media network for things like that and creates those spaces, does.
So I would argue in defiance of the purposes for its creation, it doesn’t. So it’s setting, if you’re setting it up, you have to work at it and you have to be vigilant. Oh. Because, because the very nature of it, the entropy and the base level heads towards chaos and heads towards that kind of negative engagement because that negative engagement drives clicks, it drives discourse, and it drives money.
And that’s what it’s about. None of what, we matter too, None of what capes on the couch, None of what we are really striving for. , it’s profitable under a capitalist system and therefore it’s not a priority. And so we have to fight against the tide just to gain some small fingernail claw hold to be able to say, I’m going to protect these people.
Doc Issues: You know, it’s interesting that you mentioned that because it reminds me of, I don’t know if you remember this, Anthony, but this was way, way, way early in our podcasting where there was just one, I, I still remember it was just this one person that went on this like three or four page diatribe on Reddit, just about how he felt we got it wrong, like one particular thing.
And it was related to the person said they had a traumatic brain injury, ptsd, and they
Anthony: I remember it well.
Doc Issues: Yeah. So there were two things that I thought about that in the moment. And of course now with the hindsight of three to, to three and a half years One is that I never took it personally because my point is that was that person’s lived experience.
And if there was something that I didn’t get across that I should have in the moment that, well, first of all, as a doctor, I, my thought was, okay, I didn’t wanna harm this person. That’s one thing. Of course, the other thing is if it’s one person saying that, so be it. I, I understand it and I hope I can do better for that, for that person.
But we didn’t end up get what and what I was fearing at the time, cuz it was still so early on, my fear was that one person would lead to this torrent of people that would just say like, See, this is how horrible these psychiatrists are. They clearly are, are not of the people they don’t understand and they’re trying to, to ruin society and things like that.
I went down this horrible emotional rabbit hole. I don’t think I ever actually said this, this directly. For a while there where I was like, Is this worth it? Am I just making things worse by putting out a professional voice? And thankfully because of the support of you and the support of my family, it was like, well, no, of course not.
I wouldn’t have started this in the first place. A little introvert like me wouldn’t have dare do something like this if I thought it was going to have a negative outcome. But at the same time, I still once in a while do think, like, I’m sure there’s still once in a while things that either I say or we say collectively or you say where it’s like, ooh, that, that kind of went the wrong way.
You know? And, and if that’s the case, I would like to think that we have now the type of either loyal fans or, or just even people that, that happen to pass by once in a while that would be willing to say it to us and not just like kind of sweep it under the rug. I’d, I’d like to think, as you said that, Because of our format and because of how we, I’ve, I’ve gotten the feedback from this, from, from multiple people.
The depth that we’re willing to talk about hard things sometimes, that they recognize that we are, we’ve shown enough humanity that mm-hmm. , whether it’s Twitter, whether it’s Discord, whether it’s Facebook or anything else, emails, It doesn’t matter. We’ve shown enough of the human side to this, that the platform doesn’t matter.
And that’s why I was, that’s why I was mentioning that and why I asked that question in the first place. Whether it’s YouTube and all, like hopefully we will write a book, something we can do this any way, any format, and, and, and still get the result that we. Regardless of the money, regardless of the other motivating factors or whatever.
And, and, and having this type of discussion just emboldens me to think bigger and to think greater, which is something that, as Anthony knows about me, I would never, ever, ever have said before.
Anthony: It’s not just about the humanity, it’s about the humility. Mm. And having the humility to accept and acknowledge if we step incorrectly, if we say something that someone may take out of line, mm-hmm. because again, we’ve been doing this show long enough now to your point doc, that we, we have that backlog of stuff. And I think that’s important. It’s not just the humanity, it’s the humility that has to necessarily come with that. So something I wanted to pivot to and ask Dr. Perkins is, You know, every, every guest that we’ve spoken to on the show comes from a background where they’re either a licensed therapist or a psychologist or a psychiatrist.
You, you do not have that that direct medical knowledge. You said it’s, it’s lived experience and, and things of that nature. What response has that created when you’re going to, when you’re going out, you’re given the TED Talk and you’re, you’re going out there as the mental health advocate, as someone who does not have the letters following your name that might be considered, you know, Correct.
For the field or things of that nature. And I’m not trying to ask this question in a disrespectful manner. I’m sure you understand where I’m coming from. I know. What kind of feedback are you getting as a non clinically, you know, professionally trained, quote unquote mental health professional as an advocate?
Dr. Perkins: Well, they love that I’m a pharmacist because mental health cause, well, I’m almost board certified as a psych pharmacist. I’m very close. I’m waiting for my results for my test. I wish they would just give it to me. I took it on September 26th. I’m just waiting for my results. But I’ve been in the psych area for four years now.
But they love that I’m a pharmacist because when I did start doing this, I knew I had a unique platform as a pharmacist because, and Doc can probably relate, they don’t directly say this to us, but they kind of say to us, You shouldn’t talk about your mental health problems. , don’t talk about it. Don’t talk about it.
Because then they won’t trust you. As medical professionals, again, they never fully said these things to us, but like as if I listened, because I still talked about it and I did share this with my patients as I was a pharmacist, because you could always tell with my patients, cuz I’m really good at like reading people’s faces.
And I did it with my students too. Anytime I would ask ’em if they were okay, they’d like give me this look. Like, can I tell you, and again, this is where we got the idea for we matter too about the breaking the barriers part. Cause if we, if they’re afraid to tell me, I’m like, Oh, this has something to do with mental health.
You just always know. So if I share a little bit about the fact that I have generalized anxiety disorder, a agoraphobia, you know, I deal with these things too. I take medication. If you tell them just a little bit, they feel comfortable sharing. So the fact that I was a pharmacist was just icing on the cake, honestly, because I had this platform, I should use it.
Especially because I’m talking about my mental health because a medical professional talking about their mental health is like worth their weight and gold because it doesn’t happen very frequently. Mm-hmm. . So, yeah, and that’s, and I’ve talked at pharmacy schools and to hear this pharmacy students.
They come up to you and they’re like, I have mental health issues, and being a student and hearing you talk about it as a pharmacist, Thank you so much. Yeah.
Doc Issues: So yeah, that. That’s, that’s incredibly powerful. And, and I do have a random aside with that because where I work, we actually do have a psych pharmacy residency, so I get to see some people go through this.
Yeah. Yeah. So as soon as you mention September 26th, I’m like, Yeah, our resident just did that. So it’s fascinating to hear that because at least when it comes to pharmacy, people have a general view. They don’t really know about some of the, the details the nitty gritty of what you go through.
And I have the utmost respect. I, I have to say our experienced psych pharmacists. Are teaching a few of our nurse practitioners in our system very well because they didn’t feel comfortable with certain medications in terms of prescribing. And there, there’s a lot that goes into it. And I know our doctors as well, our psychiatrists, they appreciate the feedback.
You know, they, they remind us when we’re supposed to do blood work for patients and monitoring. It’s incredible. So I don’t want to shortchange that. That’s beautiful work. That is well needed work. And, and you know, that’s one side. And then the other side, of course, as you mentioned where people don’t mention this professional disclosure is something that, at least in my training, they made it a very hard line for us.
And they just simply said, Well, you’re never supposed to say anything to any patient, ever. And I threw that out the window, I would say within the first two or three weeks because I realized the more I did that, the less authentic I felt and. I, you know, carefully, of course. I mean, I don’t go too far, but I made sure that patients recognize that life happens to all of us.
And if they saw that it happened to me in terms of either something that was relatable or something that was very direct to them, like it, it directly related to them, then that usually allowed for the person to explore things about themselves that they had walled off on their own. It wasn’t just the idea of, I can’t tell anybody else about it.
It’s, Well, if I don’t tell anybody else about it, then that means I don’t even have to deal with it myself. And, I always wanted to foster the exact opposite. Like, I can, I can talk about some of the things, whether it’s a formal diagnosis or not, I can at least say, Hey, I definitely have had panic attacks.
I definitely have had anxiety. I’ve definitely had some, negative events that have happened similar to what you just described, That just opens up the world. It, it is incredible how big a difference that can make, and I was scared to do that, where I would only do that one on one. But since I work in a hospital, I’m working with nurses, social workers, people like that, and I said, Okay, as long as I keep it separate, I realize, wait a minute, patients are gonna talk about this anyway, so I got comfortable enough where if I do that, I’ve noticed some social workers, I’ve noticed some nurses where they’ll, we are willing to have conversations with each other now that we never had before.
It’s like, hey, so how, you know, how are you dealing with that? I heard unfortunately, whatever, your sister relapsed or your, like, whatever, and, and people talk about things that they wouldn’t even talk about even within the field. That Yes, yes. That, that is one of the most rewarding things about it.
You know, I, I can’t, I can’t emphasize that enough when people, It’s a great feeling. Yeah. Yeah. It’s a great feeling. Absolutely.
Dr. Perkins: It’s just I how that, that passioned feeling. He, he’s emanating like, I get that too. And you just, you just feel it.
And it’s just like you want it to, like, you wanna pass it on . And, I did it with my students too. I mean, you could tell with my students even they wouldn’t want to share. And I just, I’d share a few things and when I was teaching pharmacy, I had a revolving door at on my door at school, and everyone would be like, How do you always have so many students?
I was like, Do you try listening? And they were like, What do you mean? And I’m like, Do you try listening? And I’m like, That’s all I do. And they’re like, It’s gotta be more than that. And I’m like, Mm, not really. It’s really not. But, and that’s, and it’s just that great feeling cuz then, you know, cuz then they talk, go to Dr. P, she talk, she listens, and they know to come to you because you’re a safe space. And so it’s just, it’s that feeling,
Anthony: that trust and that yes, that safeness, that security that again, comes with trust and that comes with, that comes from a place of no judgment, no stigma. And to your point absolutely.
Just listening. Mm-hmm. and just listening and letting them say what it is that they need to, because so many times they will talk themselves towards the solution. Mm-hmm. . And if only. Someone would give them that space. That happens. So, so many times, this is why, full disclosure, I talk to myself all the time.
If I’m alone, if I’m in the car, I will talk to myself half the time. If I’m driving to work, I’ll turn the music off and I’ll just have a conversation with myself and just follow where my brain goes. And as I’m talking things aloud, I will go, Huh, you know this. That’s very interesting. And I was just telling again, I was just talking to my sister the other day and I was explaining to her one of the reasons why I vent is not that I’m looking for you to provide me with the solution.
It’s, I’m looking for you to sit there quietly or just, Wow, that sounds really hard for you. Like, let me come to my own conclusions before jumping down my throat with what you think I should do. because what you think I should do is not necessarily what I’m going to come to. Now, I may come to that same conclusion, but it’s gonna be a lot more powerful if I do it myself.
Mm-hmm. , you know, you can lead that horse to water and you can shove the head under there until the bubbles stop, but it’s not really going to be a long-lasting and fruitful situation versus them going there and going, Oh, you know what? I think I am pretty thirsty now that I think about it. Now I’ve had a chance to process it.
So again, that listening, you know mm-hmm. , that whole, Well, we have two ears in one mouth, so we need to listen twice as much as we speak. You know, I think one of our teachers in high school said that, Doc, didn’t they? Oh yeah. Yep, yep. Yeah, some, somebody said that. Now, now one of the last things I wanna discuss, and this is something that you know, we, we keep coming back to this discussion of social media.
And it’s funny that I’m bringing this up. Not only is it something I’ve seen recently, but we also on our show, kind of had a. Very similar discussion, Entire episode kind of centered around discussions of diagnosis and on social media and things of that nature. And something that I saw recently on social media, and I, I kind of want your take on this as well, is somebody said a self-diagnosis is just as valid as one that you get from a doctor.
And now I want to just sort of explain, at least provide somewhat of a caveat that I understand that there are certain folks that may not trust doctors, they may have had bad experiences of medical professionals. And so therefore, if someone is telling you as medical professional, this is my professional opinion because I studied, I have the white coat and, and the whole nine yards and the fancy letters after my name et cetera, et cetera.
And this is therefore what I think you should do versus the lived experience that this person has, But, As we’ve seen on social media, a lot of times folks tend to say their lived experiences as representative of the whole. And I think that’s where we get into problems. And so with respect to self-diagnosis and statements of, Well, I did this and therefore this is, I believe that I have bipolar or, dissociative identity or adhd, anxiety, whatever the case may be.
As an advocate for the community and as someone who, who is a medical professional, but again, not from that necessarily not from that school of thought. What are your, I guess takes on on self-diagnosis and discussions on social media? .
Dr. Perkins: I’ll use myself as an example. So currently I am in between self-diagnosis and formal diagnosis of autism.
So I I had wondered for a while about autism. I had been questioning it. I have adhd, I have diagnosed adhd. Had my whole life. That’s no question about that one. But meeting one of my friends who, her and I are very similar recently diagnosed formally with both ADHD and autism. And I started to wonder, Cause we have a lot of similarities, I was starting to wonder, I was like, Hmm.
I was like, we do that. We both do that. And then some other things I was learning and I was starting to question my O C D diagnosis. I was like is that actually OCD or is that autism? So I started wondering, So I asked my friend, she’s the therapist. I was like, are there screening tests that you can do like official screening tests that you can do that can tell you if there’s a possibility that you’re autistic?
And she was like, Yes, there are . And I was like, Okay. So I did them. And lo and behold, as if I were shocked both of them said I was autistic. And one of them, as I was doing it, I told her, I said is this supposed to explain my entire life? And she goes, Ashley, if it’s explaining your entire life, I have some news for you.
You’re probably autistic. , . And I started laughing. I was like, Okay, thank you. So I was like, Okay. So I hadn’t said anything yet. I was like, Okay, I’m gonna let this kind of percolate. Right? I was like, I’m gonna let this process in my brain. So I scored like a 1 69 on the rat, R A A S D or d s, and then I did the autism quotient and I got a 40 on that one.
So I was like, I’m gonna let this process for a hot minute. You could see
Doc Issues: my re . Sorry about that. You could see my reaction there, .
Dr. Perkins: I know. So, but I was like, I’m gonna let this process processing. I started to read people’s, like their experiences and everything, and I started to like, look, peel my onion back.
Right? Looking back over my experiences as I was growing up, it explains a lot of things that I went through as a kid. Mm. And I’m like, . So I have a formal diagnosis set up for February , and I’m looking at my own child and I’m starting to see it in my own child. I knew like adhd, my own child was that, that we’ve been seeing and for, but I’m also seeing it in him.
So I’m, I’m like 95% sure.
So I’m in the boat of that. Self diagnosis can be valid. It should be done with the research looking into it because the problem is, is with getting in a formal diagnosis can be very hard. Like I’m waiting until February and I called in October. Mm-hmm. . So like I’m waiting a long time to get in. It can be expensive.
People don’t have access a lot of times. So like these screening tests, I mean the, but the two I used from what I understand are supposed to be pretty accurate.
Doc Issues: Yep. So here’s where I’ll jump in. Yeah,
Dr. Perkins: you go, you can go for it. Yeah.
Doc Issues: I mean, don’t get me wrong as a professional, and, and since you’re not my patient, I can’t give any formal, official diagnosis, disclaimer, et cetera, et cetera.
But I know we’re doing a podcast where people couldn’t see my face or anything, but when you gave some of the, the information and the numbers I had kind of a dramatic reaction. And my point was like, Wow, that puts a high probability and that’s, I’ll, I’ll leave it at that.
The thing I was going to say about all of this is and, and I don’t think. Hiding any secrets here? Anybody that has done anything from take a psychology course in college to, in this case, if you’re a med student and you, you went through a psychiatry rotation or whatever, we all do this. This isn’t something that’s new.
The idea that people will say things like this on social media, I get it. And, and I feel like I’ve come full circle with this. And what I mean by that is because I’m in a, in a hospital setting now professionally as, as my full-time job I will have been for my entire career, but I also did outpatient as well.
I’ve noticed my, my take on this was different. If you ask me this a decade ago, I would be much more like very, pardon my language, like tight ass about it. I would’ve said like, Oh, okay, look, there’s no way that a person is going to be able to recreate years and years of training to come to formal diagnoses and things like that.
And yet, I remember as a student, the whole point is the patient is your textbook. You learn more from the people that you’re dealing with than just reading about something. And that is the truth. And talking to colleagues about it and continuing to look at journals and updated research and continuing to, to assess your own biases about how you make diagnoses because of what you see.
I’m one of those people, unfortunately at least I’m aware of it, where half of everything I’m gonna see is gonna end up looking like bipolar because so many patients I’ve. Have had bipolar diagnoses previously and are coming in because of severe depression or suicide attempts or manic episodes and not sleeping and all this other stuff.
But I make the other diagnoses in the wide spectrum of whatever it is that is, considered mental health. I’m, I’m used to it, but I know that I have to be aware of my blind spots. And it’s a pretty good idea for a patient to come to me with their own ideas and agenda, even if it’s not something that I immediately agree with, because it opens my mind to the things that I need to consider in that person’s life.
So, let me put it this way, I may not automatically agree with what a patient says their diagnosis is, but if a patient tells me that a symptom that they’re having, I can at least validate, okay, that is something you’re experiencing for sure. This is what I’m seeing that matches that. Or maybe something you hadn’t considered either.
And we’re doing it together. It’s collaborative. It’s not a one way. So, I don’t know necessarily if it has to be something that’s declared ahead of time, especially on social media, because then that starts to impact how others are going to interact with the person. So I would, I would still exercise a significant amount of caution, but I’m, I’m not totally against the idea that someone at least starts the groundwork for their own self development.
I think that can be a wonderful thing. It doesn’t have to have, and I’ve, I’ve said this with so many patients, though, for some people, it’s not gonna come to a final label. And when I’ve talked to people where I’ve sought help for myself, I know they’re trying to be nice.
When they say it to me, they’re like, You are such a weird mix. And I can tell they didn’t want, often, they didn’t want to come to something formal with me, only because they’re like, If we pigeonhole you, you’re going to, And they know this about my personality and Anthony know this too, then you’re gonna run with it and you’re probably going to dig yourself into this rabbit hole of, of research and knowledge about that one topic and pigeonhole yourself to the point that you exclude everything else.
And technically you may make yourself worse. And that’s what other professionals have said about me. So I’m, I’m willing to acknowledge it. And I don’t hide it. I don’t. Shy away from it. So I, I’ve learned like, okay, it’s okay to go down these, down these paths and it’s great for the information and the knowledge base.
Sometimes having a Sherpa on that mountain, on that mountain climb can be really helpful though. So at, at this point, what I say to patients, I’m like, You know what? I’m not even gonna focus on the labels. I’m gonna tell you the things that I think are gonna help your life. If it makes you feel better to get that title or whatever.
If I agree with it, I’ll only do it if it’s ethical, but if I agree with it, fine, I’ll go ahead and I’ll put it there. You know, if you don’t even need it or you’d rather not because you think it’ll be hurtful, fine, cool. You know, I’ll, I’ll keep that confidential, but the point is there’s many, many ways to go about it.
I think social media has shown that I think it could be an amazing thing. I also tell people just,
Anthony: just be careful. Yeah, it’s definitely that that situation where. You, you read something and you go, Yeah, that resonates with me. And then you start focusing in on that to the perhaps, potentially.
And detrimentally, to your point doc, the exclusion of other, I don’t wanna say exculpatory evidence, but other evidence that, Well, that’s the, the lawyer in me thinking exculpatory stuff, but other evidence that might say, But you’re, you’re ignoring this other stuff that shows that it might not be that because you’re so honed in.
And, and we talked about this in, in the episodes, it was literally called drt, and it was this discussion about how folks speak about their lived experience as though it is representative. Comprehensive for a particular diagnosis and that, oh, if you have this X, Y, and Z, you therefore, you know, all people with ADHD do this.
Or, if you do X, Y, and Z, you have, you know, bipolar disorder or anxiety or whatever the case may be. And that may be true for that individual with that particular diagnosis. Mm-hmm. , it does not mean that everybody does it now. Is it great to get this broad spectrum of discussions? Absolutely. I’m of the mindset that the more people talking about this, and again to, to your organization’s point as well, if we destigmatize these discussions and we’re free to talk about this, we’re gonna find those commonalities, we’re gonna find those similarities.
We’re gonna be able to say, Huh, I’m not as different as I thought I was. Which is wonderful. It’s great to the human nature. We are by definition, social creatures. But when you start to use that as. Seeking a community solely for the purpose of, or solely building the, the community around the diagnosis to the exclusion of everything else is where I think it starts to become potentially detrimental.
So I’m a, a big fan of folks speaking honestly and truly about their life experiences. Mm-hmm. , because I think we could all stand a benefit from it. And it’s totally okay to hear someone else talk about their life experience or, listen to their TED talk or whatever the case may be, and say, Oh, that’s something that very similar, that I’ve encountered.
And if that leads you on that path of understanding and of discovery towards whatever that might be for you, that’s fantastic. It’s where you take somebody else saying, Oh, they did this, and they have whatever the disorder may be. I do this, therefore I also have this disorder. I think that’s where you, that’s where it starts to become an issue.
Dr. Perkins: And in my book I put like multiple caveats that say, Just because I have this does not mean that you do, You might recognize some of these things in you, but I, I urge you to talk to your doctor. Don’t diagnose yourself with my book . I literally say it. Cause I was like, I don’t want people taking my book into their doctor and.
Anthony: Yeah. It says here on page 73 that she experienced this, this, and this. There I, I did it too. Therefore, we are the same. I need you to diagnose me with this and the doctor’s gonna go, How about No,
Dr. Perkins: I wanted to make sure that I was being clear that this is my experience, but this is not a di because I did put research in my book.
Mm-hmm. . Mm-hmm. . So like, I wanted to be clear. Just because there’s research in here doesn’t mean that you can diagnose yourself.
Anthony: Yeah. And it, and it comes down to, your personal ethics, your professional ethics, and that need to disclose that social media doesn’t have those parameters. It doesn’t have those requirements, whether formally or informally.
So anybody can go on. TikTok and make a video and say, I have this, therefore, you know, Right. This is, dispositive of whatever the disorder might be. You writing a book with, publishers and, and things of that nature. You know that, that you are bound by those ethics and you wanna make sure that you are not unnecessarily and incorrectly steering people towards something that may or may not be truthful.
You know, is, is a credit to you. But also, as I said, it’s one of the dangers of social media. And so I, I just wanted to kind of have that discussion. I think it’s, it’s been very helpful and very enlightening that, you know, it goes back to the thing we were saying earlier. It’s all about the nuance. It’s not a binary, it is not, self-diagnosis is good, or self-diagnosis is bad, it’s self-diagnosis can be helpful on the path.
Mm-hmm. . But yes, I, you know, I push back against, You know, those kind of est type statements because I find and I recognize the meta irony within this absolute statements are never correct. , never comprehensive.
And yes, again, I’ve recognized tongue in cheek as, as it always is. So we’re gonna wrap this up then. Dr. Perkins, why don’t you give us a little bit more info on We Matter too and where folks can find you and some of the resources that are available through the organization.
Dr. Perkins: So We Matter too, is just We Matter too. Dot org, that’s our website and all of our resources and all different types of fun stuff is on the website. You can find me on Twitter. It’s at at, because I matter. And I’m on Twitter all the time, like y’all always can find me. And then all of our social media is at We Matter to I N C and that’s for Instagram, Twitter, and Facebook.
Anthony: easy. There you go. And, and the book as well. Where? Oh, book the book
Dr. Perkins: on Amazon. I matter too.
Anthony: Excellent. Buy my book. Buy my book. That is a reference that Doc might get. Oh yes. I dunno if that, Oh, the critic. Oh. I don’t know if you ever watched the critic Dr. Perkins book. I have not. Okay. That was, Wow. Yeah, that was mid to late nineties. Yeah, that, that,
Doc Issues: Wow, that, that’s obscure.
Anthony: Dr. Perkins, thank you so much for taking the time to to speak with us. This has been incredibly enlightening. We’re gonna have links to all this stuff in the show notes when this episode comes out because as our friend Chris from Play Comics always says, clicking on things is so much easier than typing things out.
And speaking of Play Comics, they are another show on the gonna Geek Network you can find not just our show, but other wonderful shows like Play Comics or Legends of Shield on the gonna geek.com website. We’re proud member of the Gonna Geek Network. We are on Facebook, Instagram, Twitter, and TikTok at Capes on the couch.
You can find all of our episodes on our website, capes on the couch.com. And thank you again so much for listening. Dr. Perkins Pleasures always, and you know, hopefully if schedules permit, we’d love to have you back on the show at some point.
Dr. Perkins: I’d love to come back.
Anthony: That is excellent, and we’re very glad to hear that. So for doc issues and Dr. Ashley Perkins, I am Anthony Sytko. Thank you for listening, and we will see you next time.