Dr Kendra Outler recently spoke with Dr Vanessa Freeman, a psychiatrist in the United States Army, in the What the Doctor Say with DrK?, the Uzima Health and Wellness podcast. DrK covered a variety of topics over the course of the episode, including Dr Freeman’s education, what drew her to a psychiatry specialty, the importance of good mental health, how to help loved ones get treatment when necessary, psychiatric help as it pertains to the Black community, and more.
About Dr Freeman
Originally from Chicago, Dr Freeman was raised in Miami. She completed her undergraduate studies at Cornell University and received her Florida International University Herbert Wertheim College of Medicine. Dr Freeman joined the military after she was accepted into medical school. The Health Professions Scholarship Program helped Dr Freeman pay for medical school in exchange for service she’d give back. Dr Freeman finished med school in the civilian sector and started her military service when she began her residency. Listen to her informative interview during Mental Health Awareness Month.
Why Dr Freeman went into psychiatry
Dr Freeman’s interest in psychiatry began when she was in high school. The seed was planted when she decided nutrition was going to be her vehicle to medical school. Dr Freeman also took Advanced Placement (AP) psychology courses, which further cemented her interest in the specialty.
“I was building a framework of understanding what a human is composed of essentially,” Dr Freeman said. “So, I wanted to study psychology, did the advanced placement courses. I realized, ‘Okay, if I’m going to go to school for seven years to be PhD clinical psychologist, I might as well be a medical doctor. That’s almost the same (amount of) time. And if I’m doing psychiatry, I’m getting to understand the psychology and then also prescribe medication.’
“But the foundation of human composition, I guess, is how I would describe it, is we are what we eat. Nutrition was kind of my access point, or at least at the time, I was thinking that I would learn about nutritional sciences, which many times can lead to psychological issues if you’re having micro or macronutrient issues or deficiencies. And so that’s kind of what I decided to go into, at least for my bachelor’s degree.”
Dr Freeman’s undergrad work in nutritional sciences explored issues that are still prevalent today, such as food deserts. People of a lower socioeconomic status can often have trouble maintaining a healthy diet due to a lack of availability of lean proteins, fruits and vegetables.
“If you were to pull up the recommended intake or recommended consumption for certain food groups, most people don’t follow that,” Dr Freeman said. “Not because they don’t want to, but most people probably can’t find three cups of fruit to have every day or even afford right now, especially with groceries being so expensive. Most people are not purchasing that many produce items to last them a whole week, let’s say, of 20 servings of fruit or vegetables.”
Working as a military psychiatrist
Dr Freeman admitted that working as a psychiatrist from a military perspective came with a unique set of challenges. She had to first learn to master the psychiatry field itself, while also learning the language that existed within the military culture. She essentially had to learn two fields at the same time.
“With psychiatry and the military, the goal is wellness,” Dr Freeman said. “That’s what we’re hoping for—overall emotional and psychological wellness. You’re also making sure that individuals are fit to be in the military. Sometimes, if you have a certain medical condition, you aren’t fit to stay in because if you’re not healthy, it’s not going to be a suitable place for you to be.”
Dr Freeman’s work with military personnel isn’t solely combat-related. Her patients also deal with other elements of trauma such as post-traumatic stress disorder (PTSD). Meanwhile, the time she’s spending in the military culture now will prove valuable when she’s working in the civilian sector and treating current and former members of the military. This is especially true of the Black military population, who will be going into the veterans system.
“I’m more than halfway through my initial time now in the military,” Dr Freeman said. “And I think it’s going to give me a level of understanding of some things that if I would’ve stayed in the civilian sector, I would not have had exposure to understand.”
How to help a loved one who may need mental health treatment
Developing an element of understanding is one of the biggest challenges people face when dealing with mental health issues, according to Dr Freeman. When someone develops symptoms of conditions such as bipolar disorder or schizophrenia, it can be scary for family members or friends because they don’t know what it looks like or what it is. Plus, signs of these disorders can look different for everyone.
Education is the key for families to help their loved one navigate what’s going on, Dr Freeman said. This means educating the family, not just the patient, so they’re aware of the signs of developing signs, which can make the situation less scary and help eliminate the uncertainty that occurs in cases like this.
“Hopefully there won’t be that fear about what’s going on and there is some knowledge about what the treatment plan or the prognosis will be,” Dr Freeman said.
Although there’s no universal diagnosis for people suffering from a mental disorder, there are signs people can look out for, according to Dr Freeman. Such signs include someone having gone several days in a row without much sleep (only an hour) and during that stretch, talking non-stop, bouncing from venture to venture, suddenly spending money recklessly or taking part in activities they don’t normally engage in like gambling. Sudden personality changes are another sign to be wary of.
“Those are signs that something is not right,” Dr Freeman said. “That is when you take your friend, family member, partner, (etc.) to the doctor and let them do the evaluations to determine what that is.”
The physician visit is crucial because from there, the doctor can connect the patient to the next level of care providers who might be needed. This could be a psychiatrist or trained behavioral professional who can help guide what the next treatment step will be.
When Drs. Outler mentioned suicide prevention as it relates to the psychiatry field, Dr Freeman noted there are a number of levels to this issue. Sometimes people simply think of going to sleep and not waking up. They might not be happy with where they are in life, feel hopeless and begin to think morbidly. The level can then escalate beyond thinking about death and actually taking one’s life. But there’s also a difference between thinking about suicide and coming up with an actual method of doing so.
“Something is happening in the person’s life to go from no thoughts of death to, ‘Now I don’t want to live,’” Dr Freeman said. “It’s usually something that can be processed or identified so that the person can move beyond that place of hopelessness to hopefully rediscover their reasons for living and what they’re hoping for in their life.”
Helping the Black community feel comfortable seeing a mental health professional
Before the conversation closed, Dr Outler asked Dr Freeman for her thoughts on the conversation that Black people do not like to go to the psychiatrist.
Dr Freeman noted that there are likely a number of reasons why the conversation exists, but a key one is fear, which stems from uncertainty. Past experiences, or history, is another one.
“But I hope as we increase the conversations about mental health and why it’s important, if there are people out there that still have the fear, or uncertainty, about if (psychiatry) is going to help them, that maybe they will start to think that there is someone out there that can understand and help them,” Dr Freeman said.
The idea that people will feel like there’s someone out there who can treat them will likely come from an increase in Black psychiatrists. Dr Freeman noted that currently only 3 percent of psychiatrists are black and there’s a chance people don’t want to see a provider if they don’t think they can relate to them.
“That’s a lot of the challenge too,” she said. “Unfortunately, there aren’t that many of us, but I hope that folks out there practicing psychiatry who don’t identify in a minority class would say the same thing as me, which is they’re focusing on the patient.
“I hope that is how they’re practicing. I hope they are taking classes and courses to achieve cultural competency because the reality is that every psychiatrist is needed and there’s not enough black psychiatrists to see all the black patients that need to be seen. So, I am hoping people will get past that fear and step out and work with the provider that they are linked with if they’re not able to find a black psychiatrist.”
Click here to listen to Dr Outler’s conversation with Dr Freeman in its entirety.